Local delivery natural products to treat periodontitis: a systematic review and meta-analysis.

Autor: de Sousa ET; Department of Health Sciences and Pediatric Dentistry, Piracicaba Dental School, University of Campinas - UNICAMP, Av. Limeira 901 Limeira Avenue, Piracicaba, SP, 13414-903, Brazil. etavaresodonto@gmail.com., de Araújo JSM; Department of Pharmacology, Anesthesiology, and Therapeutics, Piracicaba Dental School, University of Campinas - UNICAMP, 901 Limeira Avenue, Piracicaba, SP, 13414-903, Brazil., Pires AC; Department of Dentistry, State University of Paraíba - UEPB, 351 Baraúnas Street, Universitário, Campina Grande, PB, 58429-500, Brazil., Lira Dos Santos EJ; Department of Prosthodontics and Periodontics, Piracicaba Dental School, University of Campinas - UNICAMP, 901 Limeira Avenue, Piracicaba, SP, 13414-903, Brazil.
Jazyk: angličtina
Zdroj: Clinical oral investigations [Clin Oral Investig] 2021 Jul; Vol. 25 (7), pp. 4599-4619. Date of Electronic Publication: 2021 Feb 01.
DOI: 10.1007/s00784-021-03774-2
Abstrakt: Objectives: This study aimed to answer the PICO question: in adults with periodontitis, does subgingival delivery of natural products (NP) after scaling and root planing (SRP) results in a better reduction of probing pocket depth (PPD) when compared with SRP alone or SRP plus placebo?
Material and Methods: A search for trials was carried out in eight databases. Two independent investigators performed all steps of this review. PPD reduction, clinical attachment level (CAL) gain, gingival inflammation, and biofilm accumulation reduction were investigated. We conducted meta-analyses where data could be pooled.
Results: Searches yielded 4771 records, in which 27 trials fulfilled the eligibility. There was a large heterogeneity among trials (I 2  > 0.69, χ 2  < 0.000). Only four studies were at low risk of bias. The evidence quality was very low. The effectiveness of NP was demonstrated in a follow-up of 3-6 months considering PPD reduction (8 trials: 0.72 mm [95%CI: 0.23, 1.22]) and CAL gain (5 trials: 1.07 mm [95%CI: 0.36, 1.78]). A significant reduction in periodontal inflammation favors the use of NP. The biofilm accumulation reduction effect of NP was very weak or non-significant.
Conclusion: Although the high risk of bias and large heterogeneity of trials impose some restrictions on the validity of effect estimate, this review indicates that adjunctive NP better reduced the PPD when compared to SRP alone or SRP plus placebo in a follow-up of 3-6 months.
Clinical Relevance: The evidence of non-responsive patients to conventional periodontal therapy highlights the need for therapeutic alternatives to treat periodontitis.
(© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature.)
Databáze: MEDLINE
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