An economic evaluation of a chlorhexidine chip for treating chronic periodontitis - The CHIP (CHlorhexidine In Periodontitis) study

Background. The authors previously suggested that an adjunctive, controlled-release chlorhexidine, or CHX, chip may reduce periodontal surgical needs at little additional cost. This Article presents an economic analysis of the CHX chip in general dental practice. Methods. In a one-year prospective clinical. trial, 484 chronic periodontitis patients in 52 general practices across the United States were treated with either scaling and root planing, or SRP, plus any therapy prescribed by treating, unblinded dentists; or SRP plus other therapy as above but including the CHX chip. Economic data were collected from bills, case report forms and 12-month treatment recommendations from blinded periodontist evaluators. Results. Total dental charges were higher for SRP + CHX chip patients vs. SRP patients when CHX chip costs were included (P = .027) but lower when CHX chip costs were excluded (P = .012). About one-half of the CHX, chip acquisition cost was offset by savings in other charges. SRP + CHX chip patients were about 50 percent less likely to undergo surgical procedures than were SRP patients (P = .021). At the end of the trial, periodontist evaluators recommended similar additional procedures for both groups: SRP, about 46 percent; maintenance, about 37 percent; surgery, 56 percent, for SRP alone and 63 percent for SRP + CHX chip. Conclusions. Adjunctive CHX chip use for general-practice patients with periodontist increased costs but reduced surgeries over one year. At study's end, periodontists recommended similar additional surgical treatment for both groups. Clinical Implications. In general practice, routine use of the CHX chip suggests that costs will be partially offset by reduced surgery over at least one year.