Wim Teughels1, Magda Feres2, Valerie Oud1, Conchita Martín3, Paula Matesanz4, David Herrera4. 1. Department of Oral Health Sciences, KU Leuven & Dentistry (Periodontology), University Hospitals Leuven, Leuven, Belgium. 2. Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos, Brazil. 3. BIOCRAN (Craniofacial Biology) Research Group, University Complutense, Madrid, Spain. 4. ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain.
Abstract
AIM: To answer the following PICOS questions: in patients with periodontitis, which is the efficacy of adjunctive systemic antimicrobials, in comparison with subgingival debridement plus a placebo, in terms of probing pocket depth (PPD) reduction, in randomized clinical trials with at least 6 months of follow-up? MATERIAL AND METHODS: A systematic search was conducted: 34 articles (28 studies) were included. Data on clinical outcome variables changes were pooled and analysed using weighted mean differences (WMDs), 95% confidence intervals (CI) and prediction intervals (PIs), in case of significant heterogeneity. RESULTS: For PPD, statistically significant benefits (p < .001) were observed in short-term studies (WMD = 0.448, 95% CI [0.324; 0.573], PI [-0.10 to 0.99]) and long-term studies (WMD = 0.485, 95% CI [0.322; 0.648], PI [-0.11 to 1.08]). Additionally, statistically significant benefits were also found for clinical attachment level, bleeding on probing, pocket closure and frequency of residual pockets. The best outcomes were observed for the combination of amoxicillin plus metronidazole, followed by metronidazole alone and azithromycin. Adverse events were more frequently reported in groups using systemic antimicrobials. CONCLUSIONS: The adjunctive use of systemic antimicrobials in periodontal therapy results in statistically significant benefits in clinical outcomes, with more frequent adverse events in test groups using systemic antimicrobials.
AIM: To answer the following PICOS questions: in patients with periodontitis, which is the efficacy of adjunctive systemic antimicrobials, in comparison with subgingival debridement plus a placebo, in terms of probing pocket depth (PPD) reduction, in randomized clinical trials with at least 6 months of follow-up? MATERIAL AND METHODS: A systematic search was conducted: 34 articles (28 studies) were included. Data on clinical outcome variables changes were pooled and analysed using weighted mean differences (WMDs), 95% confidence intervals (CI) and prediction intervals (PIs), in case of significant heterogeneity. RESULTS: For PPD, statistically significant benefits (p < .001) were observed in short-term studies (WMD = 0.448, 95% CI [0.324; 0.573], PI [-0.10 to 0.99]) and long-term studies (WMD = 0.485, 95% CI [0.322; 0.648], PI [-0.11 to 1.08]). Additionally, statistically significant benefits were also found for clinical attachment level, bleeding on probing, pocket closure and frequency of residual pockets. The best outcomes were observed for the combination of amoxicillin plus metronidazole, followed by metronidazole alone and azithromycin. Adverse events were more frequently reported in groups using systemic antimicrobials. CONCLUSIONS: The adjunctive use of systemic antimicrobials in periodontal therapy results in statistically significant benefits in clinical outcomes, with more frequent adverse events in test groups using systemic antimicrobials.
Authors: James Rudolph Collins; Gabriel Ogando; Rolando González; Elena Figuero; María José Marín; Mariano Sanz; David Herrera Journal: Clin Oral Investig Date: 2022-02-05 Impact factor: 3.573
Authors: Maha R Taalab; Sabah Abdelhady Mahmoud; Riham M El Moslemany; Dania M Abdelaziz Journal: BMC Oral Health Date: 2021-05-05 Impact factor: 2.757