Effectiveness of metronidazole as an adjunct to scaling and root planing in the treatment of chronic periodontitis: a systematic review and meta‐analysis

Sgolastra, Fabrizio; Severino, Marco; Petrucci, Ambra; Gatto, Roberto; Monaco, Annalisa

doi:10.1111/jre.12089

Cited by 39 publications

(52 citation statements)

References 57 publications

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“…5254 Similarly, the adjunctive benefits of combining metronidazole with SRP correspond to an additional 0.1 mm of attachment gain and 0.15 to 0.18 mm of probing depth reduction. 54, 55 The combination of SRP and azithromycin yields a mean attachment gain of 0.11 mm (not statistically significant) and a mean probing depth reduction of 0.39 mm in comparison to SRP alone. 54 Meta-analysis of studies using an adjunctive doxycycline regimen failed to demonstrate a significant overall enhancement of attachment gain or probing depth.…”

Section: Efficacy Of Srp Combined With Systemic Antibioticsmentioning

confidence: 94%

“…26, 27, 39, 52–55 Their general conclusions are summarized below.

Combining systemic antibiotics with SRP can provide a greater therapeutic benefit than SRP alone.

The combination of antibiotics and SRP provides a greater benefit to patients with aggressive periodontitis than to those with chronic periodontitis.

The combination of SRP and antibiotics yields its greatest benefit at sites with deep initial probing depths.

Several different antibiotic regimens are capable of enhancing the treatment response to SRP.

…”

Section: Efficacy Of Srp Combined With Systemic Antibioticsmentioning

confidence: 96%

“… Abbreviations: MET (metronidazole), AMX (amoxicillin), CA (clavulanic acid), TET (tetracycline), DOX (doxycycline), AZM (azithromycin), SDD (sub-antimicrobial-dose doxycycline), SPIR (spiromycin), CLR (clarithromycin), ORN (ornidazole), MOX (moxifloxacin) # Main meta-analysis included three studies that examined the effect of the antibiotic as a sole treatment. * Main meta-analysis included nine studies that examined the effect of adjunctive sub-antimicrobial-dose doxycycline. Data from Refs 26,52,54,55 …”

Section: Tablementioning

confidence: 99%

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Should Antibiotics Be Prescribed to Treat Chronic Periodontitis?

Walters

Lai

2015

Dental Clinics of North America

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Synopsis While scaling and root planing is a cost-effective approach for initial treatment of chronic periodontitis, it fails to eliminate subgingival pathogens and halt progressive attachment loss in some patients. For some patients, adjunctive use of systemic antibiotics immediately after completion of scaling and root planing can enhance the degree of clinical attachment gain and probing depth reduction provided by nonsurgical periodontal treatment. This article discusses the rationale for prescribing adjunctive antibiotics, reviews the evidence for their effectiveness, and outlines practical issues that should be considered before prescribing antibiotics to treat chronic periodontitis.

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Section: Efficacy Of Srp Combined With Systemic Antibioticsmentioning

confidence: 94%

“…26, 27, 39, 52–55 Their general conclusions are summarized below.

Combining systemic antibiotics with SRP can provide a greater therapeutic benefit than SRP alone.

The combination of antibiotics and SRP provides a greater benefit to patients with aggressive periodontitis than to those with chronic periodontitis.

The combination of SRP and antibiotics yields its greatest benefit at sites with deep initial probing depths.

Several different antibiotic regimens are capable of enhancing the treatment response to SRP.

…”

Section: Efficacy Of Srp Combined With Systemic Antibioticsmentioning

confidence: 96%

Section: Tablementioning

confidence: 99%

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Should Antibiotics Be Prescribed to Treat Chronic Periodontitis?

Walters

Lai

2015

Dental Clinics of North America

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“…60 However, there is still no consensus on this statement because a larger number of randomized controlled trials with large sample sizes is needed. Two recent studies 45,61 compared the effect of systemic antibiotics (MTZ+AMX) i n smokers a nd non-smokers.…”

mentioning

confidence: 99%

Antibiotic therapy as an adjunct to scaling and root planing in smokers: a systematic review and meta-analysis

et al. 2017

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The aim of this study was to perform a systematic review and meta-analysis to examine the effect of systemic antibiotics in the periodontal treatment of smokers. The selection criteria were as follows: controlled randomized clinical trials; studies published in English; studies with smoker patients diagnosed with chronic periodontitis; patients without systemic diseases; studies that used systemic antibiotic therapy associated with periodontal treatment; studies that presented results for the test and control groups and assessments of clinical periodontal parameters, such as probing depth (PD), bleeding on probing (BOP), and clinical attachment level (CAL). The differences in average weights were calculated with a confidence interval (CI) of 95% for PD reduction, CAL gain and BOP. The means of the periodontal clinical parameters were compared between the baseline and post-treatment periods between the test groups and the control groups. The heterogeneity was assessed using the Cochran Q test (Q (df = 3), α = 5%). A total of 67 articles were found, and after the selection process, three randomized controlled trials were included in the meta-analysis. The results indicate that SRP associated with systemic antibiotics promoted additional benefits when compared to SRP alone, with a greater reduction of PD (p = 0.0359, CI = -0.42, -0.01) and a gain of CAL (p = 0.0161, CI = -0.39, -0.04). There was a modest PD reduction (PD, DM -0.21) and a modest CAL gain (CAL, DM -0.22). The results of our meta-analysis reveal the clinical benefits of systemic antibiotics as an adjunct to the non-surgical periodontal treatment of smokers. These clinical improvements, although statistically significant, appeared to be of little clinical relevance.

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“…Full-text reviews of the remaining 33 articles resulted in the exclusion of 24 articles, which left nine SRs for inclusion in the study (Table 2). [19][20][21][22][23][24][25][26][27] Figure 1 illustrates the literature search results in detail.…”

Section: Resultsmentioning

confidence: 99%

An overview of systematic reviews of the use of systemic antimicrobials for the treatment of periodontitis

et al. 2014

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Effectiveness of metronidazole as an adjunct to scaling and root planing in the treatment of chronic periodontitis: a systematic review and meta‐analysis

Abstract: The meta-analysis results seem to support the effectiveness of adjunctive MET with SRP compared to SRP alone. However, given the low number of included studies and limitations of meta-analysis, future studies are needed to confirm these results.

Cited by 39 publications

References 57 publications

Should Antibiotics Be Prescribed to Treat Chronic Periodontitis?

Should Antibiotics Be Prescribed to Treat Chronic Periodontitis?

Antibiotic therapy as an adjunct to scaling and root planing in smokers: a systematic review and meta-analysis

An overview of systematic reviews of the use of systemic antimicrobials for the treatment of periodontitis

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