Ghimas Chlo-Site Subgingival Antimicrobial Local Antiseptic Chlorhexidine Gel 1 x 0.25 ml

Chlo-Site – Bioadhesive Periodontal Gel with Controlled Release, Containing Chlorhexidine

Chlo-Site is a long-acting, controlled-release bioadhesive gel developed for subgingival application. It is xanthan-based and contains dual forms of chlorhexidine. It is used as a supportive treatment after mechanical debridement (SRP) in periodontal therapies. Thanks to its gel structure, it adheres to the tissue and can remain in the pocket for up to 20 days, thereby suppressing bacterial biofilm and preventing recolonization.

Pharmacological Structure

Chlo-Site has a patented combination containing two different forms of chlorhexidine:

• Chlorhexidine Digluconate 0.5%: Provides immediate antimicrobial effect
• Chlorhexidine Dihydrochloride 1.0%: Offers long-term effect with controlled release

Xanthan gum, as the carrier agent, ensures that the active ingredients remain in the periodontal pocket for a long time due to its dense and viscoelastic structure. This mucoadhesive property allows the material to adhere to surfaces without being rapidly washed away by oral fluids.

Mechanism of Action

• Ensures microbial death by disrupting bacterial membranes and disturbing intracellular content.
• Creates a high local chlorhexidine concentration in the subgingival area.
• Xanthan polymer slowly and continuously releases the active ingredients.
• Can remain effective for up to 20 days – preventing recolonization during this period.

Clinical Application Areas

Chlo-Site is recommended as a local therapeutic agent in various periodontal and peri-implant conditions:

• Gingivitis and early-stage periodontitis (Stage I–II)
• Deep periodontal pockets (≥5 mm) – Supportive treatment in Stage III–IV cases
• Treatment of peri-implantitis and mucositis
• Residual pocket management after SRP
• Supportive care around dental implants
• As an alternative to non-surgical periodontal treatment

Method of Clinical Application

• Mechanical debridement (SRP) must be performed before application.
• The gel is applied directly to the periodontal or peri-implant pocket with an injector.
• The 1 ml format can be used for multiple areas; the 0.25 ml format is ideal for local lesions.
• Mouthwash should not be used for the first 2 hours, and hard chewing is not recommended.
• Reapplication can be done at intervals of 1–5 weeks, depending on the healing process.

Clinical Data

In multi-center randomized controlled clinical trials, groups treated with Chlo-Site showed:

• An average reduction in probing depth of 0.8–0.9 mm.
• Significant reduction in subgingival P. gingivalis and T. forsythia levels.
• Antibacterial effect continued to be observed even at 6 months.
• The SRP + Chlo-Site combination demonstrated higher success compared to SRP application alone (p<0.001).

Forms and Packaging

• 4 x 1 ml sterile syringes – for multiple pocket applications

Advantages

• High local effect without the need for systemic antibiotic use.
• Accelerates healing time when applied after SRP.
• The only gel format that remains active for 20 days.
• High tissue compatibility, low risk of irritation.
• Can also be applied by dental hygienists.

Application Protocols According to Indications for Use

Chlo-Site allows for repeatable controlled applications in different stages of periodontal disease and peri-implant conditions, as per the clinician's decision. Clinical applications are recommended as follows, based on periodontal pocket depth and disease stage:

1. Mucositis and Gingivitis

• Before application, the area is cleaned and carefully dried.
• Chlo-Site is applied directly to the lesion area.
• If symptoms persist, the application is repeated in the next session.
• The clinician determines the follow-up interval based on PSR (Periodontal Screening and Recording Index) values.

2. Stage I Periodontitis or Pockets Shallower Than 3 mm

• After supragingival plaque is removed, Chlo-Site is applied.
• The patient is planned for reapplication for a minimum of 2 sessions.
• The number of applications can be increased based on the clinician's evaluation.

3. Stage II Periodontitis or 4 mm Pockets

• Subgingival plaque is removed (SRP is applied).
• At least 3 repeat sessions are planned after the first application.
• Additional sessions may be conducted based on observation and healing.

4. Stage III Periodontitis or Pockets Over 5 mm

• Chlo-Site is applied into the pocket after SRP.
• A minimum of 4 applications should be planned, with decisions made based on clinical follow-up.

5. Stage IV Periodontitis or Pockets Over 6 mm

• After intensive subgingival debridement (SRP), Chlo-Site is applied.
• At least 5 applications are recommended; continuity depends on disease progression.

6. Prophylactic Use in Patients with Stable Periodontal Disease

• In patients with reduced periodontium, especially with borderline measurements.
• Can be applied after supragingival cleaning during annual control sessions.
• Helps maintain periodontal status.

7. Prosthetic Implantology

• Can be applied in all spaces within the implant to be closed with a screw.
• Can be used at the fixture level as well as on prosthetic intermediate components such as MUAs (Multi Unit Abutments).

8. Preparation Before Periodontal Surgery

• Before major surgeries, to achieve healthier soft tissue.
• Applied into the sulcus or pocket after supragingival or juxtagingival cleaning.
• The application aims to reduce the microbial load of the surgical area and improve healing quality.