PERIO - Periodontal Practice Today 4 (2007), No. 1 (09.03.2007)
Are topically delivered antibiotics beneficial as an adjunct to scaling and root planing in the treatment of periodontal diseases? A systematic review
Preus, Hans R / Mjoen, Even / Romstad, Endre / Gjermo, Per
Local antibiotics have been reported successful in the treatment of destructive periodontitis. However, design, stringency and outcome of such studies seem variable. Thus our focused question was: are scaling and root planing (SRP) with adjunctive topical antibiotics superior to SRP alone in treating chronic periodontitis? Reports from 1990 and 15 years on were electronically searched in central databases using the terms 'periodontitis'/'periodontology' combined with 'local antibiotics'/'topical antibiotics'. Only randomised, blinded, controlled clinical trials (RCTs), comprising more than 20 patients diagnosed with chronic periodontitis, adjunctively treated with a single, topical antibiotic, and with a follow-up of more than 3 months were accepted. Treatment outcome was assessed by changes in clinical attachment level from baseline to end of study. The initial searches produced 198 articles, which eventually were reduced to 11 according to the inclusion criteria. The analyses of this group of articles gave no clear-cut answer to the focused question, but displayed a possible benefit of applying topical antibiotics in conjunction with SRP. However, the benefit was small and of doubtful clinical significance.
Keywords: local antibiotics, mechanical therapy, periodontitis