Systemic antimicrobials in conjunction with SRP, can offer an additional benefit over SRP alone in the treatment of periodontitis, in terms of CAL and PPD change, and reduced risk of additional CAL loss. However, differences in study methodology and lack of data precluded an adequate and complete pooling of data for a more comprehensive analyses. It was difficult to establish definitive conclusions, although patients with deep pockets, progressive or 'active' disease, or specific microbiological profile, can benefit more from this adjunctive therapy.

If systemic antimicrobials are indicated in periodontal therapy, they should be adjunctive to mechanical debridement. There is not enough evidence to support their use with periodontal surgery. Indirect evidence suggests that antibiotic intake should start on the day of debridement completion, debridement should be completed within a short time (preferably <1 week) and with an adequate quality, to optimize the results.

Objectives Recent scientific evidences suggest a relevant role of the oral cavity in the transmission and pathogenicity of SARS-CoV-2. Methods A literature search was performed in PubMed, up to April 30, 2020, focusing on SARS-CoV-2, COVID-19, oral cavity, and antimicrobial agents. Results Oral viral load of SARS-CoV-2 has been associated with the severity of COVID-19, and thus, a reduction in the oral viral load could be associated with a decrease in the severity of the condition. Similarly, a decrease in the oral viral load would diminish the amount of virus expelled and reduce the risk of transmission, since (i) during the first 10 days, the virus mainly accumulates at the nasal, oral, and pharyngeal area; (ii) the number of angiotensin-converting enzyme (ACE2) receptor is greater in the salivary glands as compared with the lungs; and (iii) salivary droplets represent the most relevant transmission route. To reduce the oral viral load, antiseptic agents may be used, although the evidence on its efficacy is indirect and weak. Conclusions Antiseptic mouth rinses, such as those containing cetylpyridinium chloride or povidone-iodine, may be able to decrease the severity of COVID-19 by reducing oral viral load in infected subjects and decreasing the risk of transmission by limiting viral load in droplets, generated in normal life, or in aerosols, produced during dental procedures. Well-designed clinical and preclinical research must be conducted to support these hypotheses. Clinical relevance Antiseptic mouth rinses may help in decreasing the severity of COVID-19 and in reducing the risk of transmission.

of adjunctive antiplaque chemical agents in managing gingivitis: a systematic review and meta-analysis. J Clin Periodontol 2015; 42 (Suppl. 16): S106-S138. doi: 10.1111/jcpe.12331. AbstractAim: The aim of this systematic review was to evaluate the efficacy of anti-plaque chemical formulations for managing gingivitis, in 6-month, home-use, randomised clinical trials (RCTs). Material and Methods: A protocol was designed, including inclusion and exclusion criteria to identify RCTs assessing gingival and/or bleeding indices. Electronic and hand-searches identified relevant papers, which were screened and evaluated for inclusion. Full-papers were retrieved and relevant information was extracted (also plaque indices), including quality and risk of bias. Mean treatment effects were calculated to obtain weighted mean differences (WMD) and 95% confidence intervals. Results: After the process of screening and selection, 87 articles with 133 comparisons, were included in the review. The additional effects of the tested products were statistically significant in terms of L€ oe & Silness gingival index (46 comparisons, WMD À0.217), modified gingival index (n = 23, À0.415), gingivitis severity index (n = 26, À14.939%) or bleeding index (n = 23, À7.626%), with significant heterogeneity. For plaque, additional effects were found for Turesky (66 studies, WMD À0.475), Silness & L€ oe (n = 26, À0.109), and plaque severity (n = 12, À23.4%) indices, with significant heterogeneity. (Beals et al. 2000); limited use of interdental cleaning (Lang et al. 1995, Stewart et al. 1997, MacGregor et al. 1998); tendency to return to baseline plaque levels in patients instructed in oral hygiene procedures (Stewart et al. 1997) or in patients enrolled in oral hygiene studies (Emilson & Fornell 1976, Lie & Enersen 1986, Yates et al. 1993, Claydon et al. 1996, Rosling et al. 1997; lack of mechanical control of other oral biofilms different from dental plaque (Quirynen et al. 1995, Greenstein 2002, 2004.The adjunctive use of chemical plaque control may be required in those subjects who are not able to effectively remove supragingival biofilms by the sole use of mechanical procedures which, in addition, reduce the amount of biofilm and disrupt its structure. There is a general consensus that plaque inhibitory and antiplaque activities of a given formulation must be proven in long-term (at least 6 months), home-use, randomised clinical trials (RCT), together with the evidence of its safety, primarily shown by the lack of relevant side effects. In these studies, the use of the tested formulations should be adjunctive to mechanical plaque control. The characteristics of this type of trial, in order to obtain valid conclusions, has been approved (Council of Dental Therapeutics 1986), and include double blindness, presence of a control group, a minimum duration of 6 months, a microbiological evaluation, and the selection of a representative population.Based on the previous information, the present systematic review was focused on those studies providing ...

In conclusion, the tested mouthrinse is effective in the treatment of oral halitosis.