Abstract | AIMS: To update the existing scientific evidence on the efficacy of local antimicrobials as adjuncts to subgingival debridement in the treatment of chronic periodontitis. MATERIAL AND METHODS: Fifty-six papers were selected, reporting data from 52 different investigations. All the studies reported changes in probing pocket depth ( PPD) and clinical attachment level (CAL) and most in plaque index (PlI) and/or bleeding on probing (BOP). Meta-analyses were performed with the data retrieved from the studies fulfilling the inclusion criteria. RESULTS: The overall effect of the subgingival application of antimicrobials was statistically significant (p = 0.000) for both changes in PPD and CAL with a weighted mean difference (WMD) of -0.407 and -0.310 mm respectively. No significant differences occurred for changes in BOP and PlI. Subgingival application of tetracycline fibres, sustained released doxycycline and minocycline demonstrated a significant benefit in PPD reduction (WMD between 0.5 and 0.7 mm). The rest of the tested outcomes demonstrated a high heterogeneity. The local application of chlorhexidine and metronidazole showed a minimal effect when compared with placebo (WMD between 0.1 and 0.4 mm). CONCLUSIONS: The scientific evidence supports the adjunctive use of local antimicrobials to debridement in deep or recurrent periodontal sites, mostly when using vehicles with proven sustained release of the antimicrobial.
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Authors | Paula Matesanz-Pérez, María García-Gargallo, Elena Figuero, Antonio Bascones-Martínez, Mariano Sanz, David Herrera |
Journal | Journal of clinical periodontology
(J Clin Periodontol)
Vol. 40
Issue 3
Pg. 227-41
(Mar 2013)
ISSN: 1600-051X [Electronic] United States |
PMID | 23320860
(Publication Type: Comparative Study, Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Review, Systematic Review)
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Copyright | © 2012 John Wiley & Sons A/S. |
Chemical References |
- Anti-Infective Agents
- Delayed-Action Preparations
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Topics |
- Anti-Infective Agents
(therapeutic use)
- Chronic Periodontitis
(drug therapy, therapy)
- Combined Modality Therapy
- Delayed-Action Preparations
- Dental Plaque Index
- Humans
- Periodontal Attachment Loss
(drug therapy, therapy)
- Periodontal Debridement
(methods)
- Periodontal Index
- Periodontal Pocket
(drug therapy, therapy)
- Treatment Outcome
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