Chlorhexidine and Zinc in Non-Surgical Periodontal Therapy (CHX-Zn)

April 18, 2026 updated by: Alparslan Dilsiz, Ataturk University

The Effect of Chlorhexidine and Zinc as Adjuncts to Non-Surgical Periodontal Therapy in Stage I and II Periodontitis: A Randomized Controlled Clinical Trial

Periodontitis is a chronic inflammatory disease affecting the supporting structures of the teeth and is associated with both local tissue destruction and systemic inflammatory responses. Non-surgical periodontal therapy, particularly scaling and root planing (SRP), is the primary treatment approach; however, it may not completely eliminate pathogenic microorganisms in all cases.

Adjunctive antimicrobial agents may improve treatment outcomes by enhancing bacterial reduction and modulating inflammation. Chlorhexidine (CHX) is widely used for its antimicrobial properties, while zinc has anti-inflammatory and immunomodulatory effects. The combined use of CHX and zinc may provide synergistic benefits in periodontal therapy.

The aim of this randomized controlled clinical trial is to evaluate the clinical and biochemical effects of CHX and zinc as adjuncts to SRP in individuals with stage I and II periodontitis.

A total of 44 systemically healthy participants will be randomly assigned to two groups. The test group will receive SRP with CHX and zinc, while the control group will receive SRP with distilled water. Clinical periodontal parameters (Plaque Index, Bleeding on Probing, Probing Pocket Depth, and Clinical Attachment Level) and biochemical markers (C-reactive protein, high-sensitivity CRP, Oncostatin M, and Antistreptolysin O) will be evaluated at baseline, 1 month, and 3 months.

The results of this study are expected to provide evidence regarding the potential benefits of CHX and zinc in improving periodontal treatment outcomes and reducing systemic inflammation.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Periodontitis is a multifactorial chronic inflammatory disease characterized by the destruction of tooth-supporting tissues, including gingiva, periodontal ligament, and alveolar bone. It is initiated by microbial dental plaque and modulated by the host immune response, leading to both local tissue damage and systemic inflammatory effects.

Scaling and root planing (SRP) is the gold standard for non-surgical periodontal therapy and aims to mechanically remove plaque and calculus from root surfaces. However, due to anatomical limitations and microbial persistence in periodontal pockets, SRP alone may not always achieve optimal clinical outcomes. Therefore, adjunctive antimicrobial and anti-inflammatory agents have been proposed to enhance treatment efficacy.

Chlorhexidine (CHX) is considered the gold standard antiseptic in dentistry due to its broad-spectrum antimicrobial activity and substantivity. Zinc, on the other hand, has been shown to possess anti-inflammatory, antioxidant, and immunomodulatory properties. The combination of CHX and zinc may provide a synergistic effect by reducing microbial load while simultaneously modulating the host inflammatory response.

This study is designed as a single-center, randomized, controlled, prospective clinical trial conducted at the Department of Periodontology, Faculty of Dentistry, Ataturk University. A total of 44 systemically healthy individuals aged between 18 and 65 years with stage I and II periodontitis will be included.

Participants will be randomly allocated into two groups using a coin-toss method:

  • Test group: SRP with chlorhexidine and zinc
  • Control group: SRP with distilled water

All participants will receive standardized oral hygiene instructions prior to treatment. SRP procedures will be performed using ultrasonic instruments. In the test group, chlorhexidine and zinc solution will be used during the procedure, whereas distilled water will be used in the control group.

Clinical periodontal parameters including Plaque Index (PI), Bleeding on Probing (BOP), Probing Pocket Depth (PPD), and Clinical Attachment Level (CAL) will be recorded at baseline, 1 month, and 3 months. In addition, blood and saliva samples will be collected at the same time points to analyze biochemical markers including C-reactive protein (CRP), high-sensitivity CRP (hs-CRP), Oncostatin M (OSM), and Antistreptolysin O (ASO) using ELISA methods.

The primary objective of this study is to evaluate the clinical effectiveness of CHX and zinc as adjuncts to SRP. The secondary objective is to assess their effects on systemic inflammatory biomarkers.

The findings of this study are expected to contribute to the understanding of adjunctive treatment strategies in periodontal therapy and may support the use of CHX and zinc combination as a practical and effective approach in clinical practice.

Study Type

Interventional

Enrollment (Actual)

44

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
    • Erzurum
      • Erzurum, Erzurum, Turkey (Türkiye)
        • Atatürk University Faculty of Dentistry

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Individuals aged between 18 and 65 years
  • Systemically healthy individuals
  • Diagnosed with Stage I or Stage II periodontitis according to the 2017 classification
  • Having probing pocket depth ≤5 mm and clinical attachment loss ≤4 mm
  • Having a sufficient number of teeth for periodontal evaluation
  • Willing to participate and able to provide informed consent

Exclusion Criteria:

  • Presence of systemic diseases affecting periodontal health
  • Pregnancy or breastfeeding
  • Smoking
  • Use of antibiotics or anti-inflammatory drugs within the last 6 months
  • History of periodontal treatment within the last 6 months
  • Fewer than 15 teeth present
  • History of radiotherapy or chemotherapy

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Chlorhexidine-Zinc Adjunctive SRP
Participants receive scaling and root planing with adjunctive chlorhexidine and zinc.
Procedure: Chlorhexidine and zinc application
Scaling and root planing is performed using an ultrasonic device with a solution containing chlorhexidine and zinc.
Active Comparator: SRP with Distilled Water
Participants receive scaling and root planing (SRP) using an ultrasonic device with distilled water.
Procedure: Scaling and root planing with distilled water
Scaling and root planing is performed using an ultrasonic device with distilled water.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Probing Pocket Depth (PPD)
Time Frame: Baseline, 1 month, and 3 months
Measurement of periodontal pocket depth in millimeters to evaluate clinical periodontal improvement.
Baseline, 1 month, and 3 months
Clinical Attachment Level (CAL)
Time Frame: Baseline, 1 month, and 3 months
Assessment of clinical attachment level in millimeters as an indicator of periodontal tissue healing.
Baseline, 1 month, and 3 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Plaque Index (PI)
Time Frame: Baseline, 1 month, and 3 months
Measurement of dental plaque accumulation.
Baseline, 1 month, and 3 months
Bleeding on Probing (BOP)
Time Frame: Baseline, 1 month, and 3 months
Assessment of gingival bleeding following periodontal probing.
Baseline, 1 month, and 3 months
C-Reactive Protein (CRP)
Time Frame: Baseline, 1 month, and 3 months
Measurement of systemic inflammatory response using serum CRP levels.
Baseline, 1 month, and 3 months
High-Sensitivity C-Reactive Protein (hs-CRP)
Time Frame: Baseline, 1 month, and 3 months
Measurement of low-grade systemic inflammation using high-sensitivity CRP levels.
Baseline, 1 month, and 3 months
Oncostatin M (OSM)
Time Frame: Baseline, 1 month, and 3 months
Evaluation of inflammatory cytokine levels associated with periodontal disease.
Baseline, 1 month, and 3 months
Antistreptolysin O (ASO)
Time Frame: Baseline, 1 month, and 3 months
Measurement of systemic immune response related to streptococcal exposure.
Baseline, 1 month, and 3 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Ataturk University

Investigators

  • Principal Investigator: Alparslan Dilsiz, Professor, Ataturk University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

June 16, 2025

Primary Completion (Actual)

March 26, 2026

Study Completion (Actual)

April 1, 2026

Study Registration Dates

First Submitted

April 2, 2026

First Submitted That Met QC Criteria

April 2, 2026

First Posted (Actual)

April 8, 2026

Study Record Updates

Last Update Posted (Actual)

April 22, 2026

Last Update Submitted That Met QC Criteria

April 18, 2026

Last Verified

April 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • ATAUNI-CHX-ZINC-2025

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data (IPD) will not be shared due to privacy and confidentiality considerations. The study involves a limited number of participants from a single center, and no formal data-sharing plan has been established.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Clinical Trials on Periodontitis

Clinical Trials on Chlorhexidine and zinc application

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

CROs by country

CROs in Philippines

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

Subscribe