Adjunctive systemic antimicrobials for the non-surgical treatment of chronic and aggressive periodontitis

Khattri, Shivi; Arora, Ankita; Sumanth, Kumbargere N; Eachempati, Prashanti; Bhat, Kishore; Kusum, Chandan Kumar; Johnson, Trevor; Lodi, Giovanni

doi:10.1002/14651858.cd012568

Cited by 11 publications

(16 citation statements)

References 56 publications

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“…This review found improvement in PD and CAL levels. These results corroborate those reported by other systematic reviews that indicate that the adjunctive management of systemic antimicrobials in the active phase of periodontitis therapy led to a statistically significant supplementary full-mouth PD diminution and CAL benefit [ 7 , 30 ]. The results of the review by Teughels et al [ 30 ] also highlight the benefits of MOX in these parameters.…”

Section: Discussionsupporting

confidence: 90%

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Clinical and Microbiological Efficacy of Adjunctive Systemic Quinolones to Mechanical Therapy in Periodontitis: A Systematic Review of the Literature

Medina

Bedoya-García

2022

International Journal of Dentistry

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Objectives. To assess the clinical and microbiological efficacy of systemic quinolones adjunctive to mechanical therapy in periodontitis patients. Materials and Methods. A systematic review of the scientific literature was carried out. The search scheme comprised the Scopus, PubMed/MEDLINE, SCIELO (Scientific Electronic Library Online), and LILACS (Literatura Latinoamericana y del Caribe en Ciencias de la Salud) databases, together with the gray literature. MeSH terms and keywords were utilized to explore publications in all idioms. Only randomized clinical trials (RCTs) that met the selection criteria were included. Results. A total of 4 RCTs were selected. These RCTs found superior clinical and microbiological efficacy of adjunctive systemic moxifloxacin (MOX) and levofloxacin (LV) compared to subgingival debridement plus placebo. Improvements in PD and CAL were 2.4 ± 0.8 mm and 2.7 ± 0.9 mm for LV, and 1.5 ± 0.5 mm and 1.8 ± 0.5 mm for MOX, respectively. After six months of follow-up, adjunctive MOX reduced the presence of Aggregatibacter actinomycetemcomitans to imperceptible levels, while LV markedly reduced this microorganism. Some adverse events were reported in the LV group and none in the MOX group. Conclusions. Adjunctive MOX and LV improve probing depth and clinical attachment level compared with subgingival debridement alone in patients with periodontitis. The efficacy of these quinolones against A. actinomycetemcomitans was also superior.

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Section: Discussionsupporting

confidence: 90%

“…The results of the review by Teughels et al [ 30 ] also highlight the benefits of MOX in these parameters. A similar situation is documented by Khattri et al [ 7 ] during adjunctive systemic use of MOX and LV in periodontitis treatment.…”

Section: Discussionsupporting

confidence: 81%

Clinical and Microbiological Efficacy of Adjunctive Systemic Quinolones to Mechanical Therapy in Periodontitis: A Systematic Review of the Literature

Medina

Bedoya-García

2022

International Journal of Dentistry

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“…CP patients present increased production of systemic inflammatory cytokines (tumoral necrosis factor alpha [TNF-α], interleukin-1 beta , and interleukin-6 [IL-6]) (Górska et al 2003) which can induce the acute phase plasma protein synthesis, such as the C-reactive protein (CRP), (Craig et al 2003(Craig et al , loos 2005) and reduce the serum albumin level (hypoalbuminemia) (Kolte et al 2010, Amitha et al 2012, Saravanan et al 2012, Patil et al 2015. the acute phase response is the effort made by the organism to restore the homeostasis and eliminate the cause of imbalance, resulting in systemic effects (Loos 2005, Marcaccini et al 2009, Pradeep et al 2011 t h e p r i m a r y e t i o l o g i c a g e n t i s periodontopathogenic bacteria that can cause destruction of the periodontal tissues directly through the action of its components, particularly the lipopolysaccharide (lPS) present in the cell wall of gram-negative bacteria (e.g., Porphyromonas gingivalis, Tannerella forsythia, Prevotella intermedia), and indirectly, by stimulating the host cells to secrete inflammatory mediators that guide and regulate the destructive activity (Khattri et al 2017). thus, it is extremely important to stop and control the invasion of microorganisms in the subgingival environment as part of periodontal therapy, either with clinical subgingival scaling and root planning procedures or with systemic antibiotics (Van der Velden 2017, Drisko 2014).…”

Section: Introductionmentioning

confidence: 99%

Relationship between periodontal outcomes and serum biomarkers changes after non-surgical periodontal therapy

Lobão¹,

Carvalho²,

Leite³

et al. 2019

An. Acad. Bras. Ciênc.

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The systemic effect of chronic periodontitis (CP) has been suggested by several studies as an etiologic factor and modulator of diseases based on the changes in the inflammatory marker levels. This study aimed to investigate the relationship between the changes in clinical periodontal outcomes and serum biomarkers (CRP, Il-6, albumin and percentage of leukocytes) after non-surgical periodontal therapy in systemically healthy adults. An interventional study was conducted with a sample of 29 individuals without CP (control group) and 33 with CP (CP group). Periodontal clinical variables were recorded, and the serum levels of inflammatory markers were measured. Statistical analysis included the chi-square and Student's t-tests and Pearson's correlation analysis. After 90 days of non-surgical periodontal treatment, a reduction of periodontal parameters and Il-6 in both groups could be observed (P < 0.001). the correlation analysis revealed a directly proportional correlation between changes in the probing depth (r = 0.349, P = 0.049) and clinical attachment level (r = 0.374, P = 0.034) with CRP in the CP group. The findings suggest a reduction of Il-6 serum concentration and periodontal clinical measures 90 days after periodontal therapy in both groups.

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“…On the whole, the repeated use of LDAs seems to be lacking in statistical and clinical significance with all included studies demonstrating some concerns and a high risk of bias. A minimum of 2 mm change in attachment level was proposed in a Cochrane review for a minimally important clinical difference in effectiveness [58]. Minor to moderate post-treatment adverse events were reported in 4 studies (25%) utilizing various adjuncts.…”

Section: Summary Of Findingsmentioning

confidence: 99%

Clinical Efficacy of Repeated Applications of Local Drug Delivery and Adjunctive Agents in Nonsurgical Periodontal Therapy: A Systematic Review

2021

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The aim of this systematic review is to compare the clinical efficacy of repeated applications of local drug delivery and adjunctive agents (LDAs) in nonsurgical periodontal therapy (NSPT) compared to subgingival mechanical debridement (SMD) alone. The Cochrane Central Register of Controlled Trials, MEDLINE, PubMed, EMBASE, Web of Science, hand-searched literature and grey literature databases were searched for randomized controlled clinical trials (RCTs) with a minimum of 6-month follow-up. The outcomes of interest were changes in probing pocket depth and clinical attachment level as well as patient-centred outcomes. Of 1094 studies identified, 16 RCTs were included in the qualitative analysis. Across 11 different adjuncts analysed, only two studies utilizing minocycline gel/ointment and antimicrobial photodynamic therapy (aPDT) with indocyanine green photosensitizer had statistically significant differences in primary outcomes when compared to their control groups. Only one study on aPDT methylene blue 0.005% had compared single versus multiple applications against its control group. A mean range of 0.27–3.82 mm PD reduction and −0.09–2.82 mm CAL gain were observed with repeated LDA application. Considerable clinical heterogeneity and methodological flaws in the included studies preclude any definitive conclusions regarding the clinical efficacy of repeated LDA applications. Future RCTs with a direct comparison between single and repeated applications should be conducted to confirm or refute the clinical advantages of repeated LDA application in the nonsurgical management of periodontitis.

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Adjunctive systemic antimicrobials for the non-surgical treatment of chronic and aggressive periodontitis

Abstract: Adjunctive systemic antimicrobials for the non-surgical treatment of chronic and aggressive periodontitis (Protocol)

Cited by 11 publications

References 56 publications

Clinical and Microbiological Efficacy of Adjunctive Systemic Quinolones to Mechanical Therapy in Periodontitis: A Systematic Review of the Literature

Clinical and Microbiological Efficacy of Adjunctive Systemic Quinolones to Mechanical Therapy in Periodontitis: A Systematic Review of the Literature

Relationship between periodontal outcomes and serum biomarkers changes after non-surgical periodontal therapy

Clinical Efficacy of Repeated Applications of Local Drug Delivery and Adjunctive Agents in Nonsurgical Periodontal Therapy: A Systematic Review

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