Efficacy of Xanthan‐Based Chlorhexidine Gel in Peri‐Implant Mucositis Treatment: A Split‐Mouth Randomized Clinical Trial

Objectives: To investigate the potential benefits of Xanthan-based chlorhexidine gel application in addition to professional mechanical plaque removal (PMPR) in the treatment of peri-implant mucositis (PM). Material and methods: Subjects diagnosed with PM were consecutively included in this randomized split-mouth study. All participants received a single session of PMPR using titanium curettes, followed by the application of an air-polishing glycine powder device. Implants allocated to the Test group were additionally treated with local delivery of Xanthan-based chlorhexidine gel. Clinical evaluation was performed at T0 (i.e., baseline), at 30 (T1), 90 (T2) and 180 days (T3) after treatment, while treatment success was evaluated at T2 and T3. Change in bleeding on probing (BoP) was considered as primary outcome measure. A logistic multivariate regression model was developed to explore the predictive role of implant and patient-level variables on primary outcome measure. Results: Fifty-nine patients (mean age: 65.4 ± 8.7 years; 54.2% male; 88.1% non-smokers) and 182 implants completed the study. At T1, only the Test group displayed a significant reduction in BoP (p < 0.001), PPD (p = 0.021) and PI (p = 0.021) compared to T0, while at T2 and T3 clinical improvements were recorded within both groups without any statistically significant difference between groups (p > 0.05). T2 Treatment success as well as the frequency distribution of complete (BoP = 0) and partial (BoP ≤ 1, ≤ 2, ≤ 3) disease resolution did not significantly differ between groups (p > 0.05). Multiple regression model revealed that smoking (p = 0.008), and implant position (i.e., premolar p = 0.009) did significantly affect the primary outcome measure. Conclusion: The adjunctive use of XanCHX gel did not result in any statistically significant clinical benefit compared to PMPR alone in the treatment of PM up to 6 months, despite the reported clinical positive effects within the first month after treatment.