Systemic and Local Delivery of Antibiotics in Managing Periodontal Diseases: An Update

Abstract

The aim of this update was to evaluate the use of local and systemic antibiotics for the treatment of periodontal diseases. Due to the accumulation of bacteria in the form of dental plaque, the tissues and bone surrounding the teeth can become infected leading to periodontal diseases such as gingivitis and periodontitis. The main purpose of periodontal therapy is to eliminate or control the undesired effects of these bacteria present in the oral cavity in the form of biofilms. The use of antibiotics in conjunction with mechanical instrumentation has been suggested for the successful treatment of periodontal diseases. PubMed and google scholar databases were used to search through the past 30 years of literature using selected search criteria “Periodontal diseases*[TW] AND (gingivitis*[TW] OR periodontitis*[TW] OR antibiotics*[TW])” to identify articles/book chapters discussing polymerization shrinkage and possible solutions. In total, 46 articles/book chapters met the criteria for inclusion in the literature review. It can be concluded that the use of antibiotics is justified in cases with rapid signs and symptoms of destruction of periodontal tissues. Hence, antibiotics are suggested in cases of aggressive periodontitis, periodontal abscess, necrotizing ulcerative gingivitis, necrotizing ulcerative periodontitis and periodontitis that do not respond well to mechanical instrumentation alone. However, antibiotics may cause side effects and the bacteria may develop resistance, therefore dentists should keep in mind the adverse effects and benefits while prescribing antibiotics. Moreover, antibiotics should always be given as an adjunct to mechanical instrumentation and oral hygiene instructions to achieve successful outcome.

A Current Review of Local Metronidazole Antibiotics for the Treatment of Periodontal Disease

“…According to the World Dental Federation (FDI), approximately 10% of antibiotics are prescribed by dentists, and the World Health Organization predicts that by 2050, ten million deaths per year will result from the improper use of antibiotics, which can lead to antibiotic resistance. Furthermore, resistant bacteria can be transmitted from one person to another through contact and other modes of transmission (Khabeer et al 2021). Thus, a low dose of MET is preferable to reduce the side effect on the gastrointestinal system as well as to minimize the chances of bacterial resistance (Zhang et al, 2017).…”

Diagnosing an Acute Leukemia From a Necrotizing Ulcerative Gingivitis in The Oral Cavity: a Case Report

“…Tetracycline, penicillin, metronidazole, a combination of penicillin and metronidazole, and clindamycin are the recommended antibiotics for periodontal disease. 20 Paracetamol reduces sub-febrile symptoms and also reduces pain. NSAIDs that are often used in dentistry include; ibuprofen, mefenamic acid, ketoprofen, ketorolac, flurbiprofen, and paracetamol.…”