Gels as adjuvant to non-surgical periodontal therapy: A systematic review and meta-analysis

Gegout, Pierre-Yves; Stutz, Céline; Huck, Olivier

doi:10.1016/j.heliyon.2023.e17789

Cited by 5 publications

(5 citation statements)

References 101 publications

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“…Furthermore, Isola et al demonstrated a decrease in bacteria of the red complex, in this case, after 15, 30, 60, and 180 days, and such differences remained for up to a year (p < 0.001). A recent review [12] showed that non-surgical periodontal treatment associated with chlorhexidine gel did not lead to any statistical significance in the reduction in PPD at 3-month follow-up compared to the control group (0.49 [1.13, 0.14], p = 0.05). This is partly in disagreement with the findings of the present review: regarding sulphonated gel, a statistically significant difference was found with respect to the control group (p = 0.007), while NaOCl showed no statistical significance (p = 0.10).…”

Section: Discussionmentioning

confidence: 99%

“…These findings are consistent with this review, as it can be concluded that a total of six studies [21,[25][26][27][28] reported a statistically significant difference in BOP reduction in favor of the test group, even if not at all follow-up intervals. According to Gegout's review [12], Khalil's study [32] reported a baseline bleeding index of 70.28% and 71.02% in the control and test group, respectively, decreasing to 44.22% and 22.03% (p < 0.001) after 3 months. Iorio-Siciliano [24] also described decreasing bleeding rates at 6 months: in the test group, rates decreased from 85.3% to 2.2%; in the control group, rates decreased from 81.6% to 7.3% (with p = 0.001).…”

Section: Discussionmentioning

confidence: 99%

“…Almost all studies demonstrated a significant reduction in PPD from baseline to followup, and five studies reported a significant result in favor of the test group; Radulescu and Megally [23,28] showed no statistical significance at any follow-up. Referring to the most recently published reviews about the application of several topical agents' gels, including antibiotics [12], the meta-analysis failed to demonstrate a significant improvement in PPD at 3 months (0.50 [1.20, 0.20] p = 0.16) in sites treated with SRP + metronidazole compared to SRP as monotherapy (placebo gel). In contrast, tetracyclines showed a significant improvement in PPD at 3 months (0.51 [0.71, 0.31], p <0.001) compared to control.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, the additional use of ozone therapy, laser, and photodynamic therapy has been reported [12][13][14]. Because of their action against anaerobic bacteria, the use of these physical agents is currently being discussed in cases of post-extraction complications and in patients with chronic gingivitis, periodontitis, and periodontal abscesses [15].…”

Section: Introductionmentioning

confidence: 99%

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Topical Agents in Biofilm Disaggregation: A Systematic Review and Meta-Analysis

Pardo,

Fiorini,

Zangani

et al. 2024

JCM

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Background: to evaluate the effectiveness of different topical agents in biofilm disaggregation during non-surgical periodontal therapy. Methods: the search strategy was conducted according to the PRISMA 2020 on Pubmed, Cochrane Library, Scopus, and Web of Science, and it was registered in PROSPERO, ID: CRD42023474232. It included studies comparing non-surgical periodontal therapy (NSPT) with and without the application of topical agents for biofilm disruption. A risk of bias analysis, a qualitative analysis, and a quantitative analysis were performed. Results: out of 1583 records, 11 articles were included: 10 randomized clinical trials and one retrospective analysis. The total number of participants considered in the 11 articles included in the study was 386. The primary outcomes were probing pocket depth (PPD), clinical attachment level (CAL), and bleeding indices. The secondary outcomes were plaque indices, gingival recessions, and microbiological parameters. The meta-analysis revealed the following: [Weighted mean difference (WMD): −0.37; 95% confidence interval (CI) (−0.62, −0.12), heterogeneity I2: 79%, statistical significance p = 0.004]. Conclusions: the meta-analysis of probing pocket depth reduction (PPD) between baseline and follow-up at 3–6 months showed a statistically significant result in favor of sulfonated phenolics gel. The scientific evidence is still limited and heterogeneous; further randomized clinical trials are required.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Topical Agents in Biofilm Disaggregation: A Systematic Review and Meta-Analysis

Pardo,

Fiorini,

Zangani

et al. 2024

JCM

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“…Therefore, the use of the stated antimicrobials for local and systemic drug administration can effectively treat patients with severe generalized periodontal disease. This discovery, together with the objective of limiting antibiotic usage [42][43][44], indicates that the antimicrobial treatment of severe periodontitis with local adjuvants, such as the combination of piperacillin plus tazobactam, may be of clinical interest [45,46].…”

Section: Discussionmentioning

confidence: 99%

Comparative Study of Systemic vs. Local Antibiotics with Subgingival Instrumentation in Stage III–IV Periodontitis: A Retrospective Analysis

Ilyes,

Boariu,

Rusu

et al. 2024

Antibiotics

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To improve the clinical and microbiological outcomes of non-surgical mechanical periodontal therapy, the adjunctive use of antimicrobials has been utilized in treating moderate-to-severe periodontitis. In our study, the retrospective design included previously collected health-related patient data, obtained from the printed and digital charts of patients who received systemic or local antibiotic adjuncts to SI (subgingival instrumentation). A total of 34 patients (diagnosed with generalized Stage III/IV periodontitis) met the inclusion and exclusion criteria and were evaluated. The samples were tested for the following bacterial strains: Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans), Porphyromonas gingivalis (P. gingivalis), Prevotella intermedia (P. intermedia), Tanererella forsythia (T. forsythia), and Treponema denticola (T. denticola). The inter-group comparisons of the bacterial species did not show statistically significant differences between groups. The present study aimed to evaluate the clinical effects after SI and the adjunctive use of systemically administered (SA) AMX (amoxicillin) + MET (metronidazole) (administered for 7 days), with locally delivered (LDD) piperacillin + tazobactam in step 2 of periodontal therapy. Results: Overall, all parameters were improved in the groups, with a significant difference in inter-group comparison regarding the full-mouth bleeding score (FMBS) (p < 0.05) in favor of the SA group, and the p-value < 0.05 was considered to be statistically significant. Statistically significant PPD (probing pocket depth) reductions and CAL (clinical attachment level) gains were observed in both groups at the 3-month follow-up. In conclusion, within the limitations, the outcomes of this study suggest that SI, with adjunctive local or systemic antibiotic therapy, provided comparable clinical improvements. Systemic AMX + MET protocols were more efficacious with regard to the reduction in FMBS. Follow-up studies with larger patient numbers are needed to further investigate this effect.

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Formulation and Release of Active Pharmaceutical Ingredients Using a Supramolecular Self‐Healing Two‐Component Gel

El‐Qarra,

Cosottini,

Tangsombun

et al. 2024

Chemistry A European J

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A two‐component low‐molecular‐weight gelator (LMWG) formed from a modified amino acid and an aldehyde was formulated with active pharmaceutical ingredients (APIs). Basic APIs (propranolol, atropine) can be mixed with the LMWG prior to gel assembly while acidic APIs (naproxen, rosuvastatin) inhibit assembly by disrupting the LMWG imine bond and were loaded by diffusion after gel assembly. For diffusion‐loaded gels, the API in the liquid‐like phase was rapidly released, with the remainder, interacting with gel fibres, retained in the gel. Rosuvastatin release was particularly low with STD NMR indicating interactions between the aromatic ring and the self‐assembled gel network. Propranolol also interacted with the gel via its aromatic unit, and its release led to gel erosion. Using agarose as a polymer gelator additive reinforced the gel, restricting erosion. In contrast, atropine was readily released over a period of hours – it is primarily in the liquid‐like phase with STD NMR indicating no interactions with the gel network. The atropine‐loaded gel retained its thixotropic properties. Overall, APIs must be carefully chosen to optimise formulation/release. Of the APIs investigated, atropine has most potential for further development. Atropine has applications in treating myopia, and our results suggest potential ophthalmic applications of supramolecular gels.

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Gels as adjuvant to non-surgical periodontal therapy: A systematic review and meta-analysis

Cited by 5 publications

References 101 publications

Topical Agents in Biofilm Disaggregation: A Systematic Review and Meta-Analysis

Topical Agents in Biofilm Disaggregation: A Systematic Review and Meta-Analysis

Comparative Study of Systemic vs. Local Antibiotics with Subgingival Instrumentation in Stage III–IV Periodontitis: A Retrospective Analysis

Formulation and Release of Active Pharmaceutical Ingredients Using a Supramolecular Self‐Healing Two‐Component Gel

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