Elsevier

Dental Abstracts

Volume 61, Issue 4, July–August 2016, Pages 221-222
Dental Abstracts

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Adding antibiotics to scaling and root planing

https://doi.org/10.1016/j.denabs.2016.03.046Get rights and content

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Background

The treatment of aggressive periodontitis often combines scaling and root planing (SRP) with various systemic antibiotics. The effectiveness of these antibiotics and the differences in effectiveness between antibiotic regimens remain little understood. A systematic review and meta-analysis were undertaken to determine antibiotic effectiveness and comparative efficacy when combined with SRP for patients with untreated aggressive periodontitis.

Methods

The MEDLINE-PubMed database search extended to January 20, 2014 and sought articles comparing SRP plus antibiotics and SRP alone with respect to clinical outcome in patients with aggressive periodontitis. Fourteen articles met the eligibility criteria. The clinical outcome measures were mean probing pocket depth (PPD) reduction, mean clinical attachment level (CAL) gain, and mean bleeding on probing (BOP) change. PPD reduction and CAL gain were both determined for moderate and deep pockets as

Results

PPD reduction was observed to be significantly better after 3, 6, and 12 months for patients undergoing SRP and MET+AMOX compared to SRP alone. No statistically significant difference was noted for DOX, MET, TET, or AZI. However, for AZI, MET, TET, and DOX only one study was available. These findings held for moderate and deep pockets as well as overall.

CAL gain was significantly greater after 3, 6, and 12 months for patients having SRP and MET+AMOX compared to SRP alone. No statistically

Discussion

Evidence indicates that combining SRP with the antibiotics amoxicillin and metronidazole achieves the best outcome when treating aggressive periodontitis. The initial mean effect of the adjunctive systemic antibiotics remains stable for at least 1 year in terms of PPD, CAL, and BOP measurements.

Clinical Significance

To best manage patients with aggressive periodontitis, systemic antibiotics should be added to SRP. The results are significantly better than those achieved with SRP alone. Because

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Keestra JAJ, Grosjean I, Coucke W, et al: Non-surgical periodontal therapy with systemic antibiotics in untreated aggressive periodontitis patients: A systematic review and meta-analysis. J Periodont Res 50:689-706, 2015

Reprints available from JAJ Keestra, Dept of Oral Health Sciences, Periodontology, KU Leuven – Univ of Leuven and Dept of Periodontology, Univ Hospitals Leuven Kapucijnenvoer 33, B-3000 Leuven, Belgium; fax: +(32) 16 332484; e-mail: [email protected]

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