Effect of locally delivered adjunctive antibiotics during surgical periodontal therapy: a systematic review and meta-analysis
| Autor: | Karim M. Fawzy El-Sayed, Sarah Yusri, Ahmed Elfana, Weam Elbattawy |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Plaque index medicine.drug_class Periodontal surgery Bleeding on probing Antibiotics Oral Surgical Procedures Review law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Internal medicine Surgical medicine Humans Adverse effect Dental Care General Dentistry business.industry Periodontal therapy 030206 dentistry Confidence interval Anti-Bacterial Agents Local Meta-analysis Systematic review Dental Scaling medicine.symptom Periodontal Index business Anti-bacterial 030217 neurology & neurosurgery |
| Zdroj: | Clinical Oral Investigations |
| ISSN: | 1436-3771 |
| Popis: | Aim The present study aimed to systematically assess current evidence on effects of locally delivered antibiotics during periodontal surgery compared to periodontal surgery alone on clinical attachment level (CAL) gain, probing pocket depth (PPD) reduction, recession depth (RD) changes, gingival index (GI), bleeding on probing (BOP), and plaque index (PI). Methodology MEDLINE-PubMed, Cochrane-CENTRAL and Scopus databases were searched up to April 2021 for randomized clinical trials (RCT), evaluating effects of locally delivered antibiotics during periodontal surgery. CAL gain served as primary, while PPD reduction, RD changes, GI and PI as secondary outcomes. The Cochrane Risk of Bias Tool was used to assess possible bias. Data were extracted, and meta-analysis was performed where appropriate. Result Screening of 2314 papers resulted in nine eligible studies. No adverse events were reported. Data on outcome variables were pooled and analyzed using generic inverse variance model and presented as weighted mean difference (WMD) and 95% confidence interval (95% CI). Statistically significant improvements in favor of antibiotics’ delivery were observed in studies with follow-up of ≤6 months for CAL gain (WMD = 0.61 mm (95% CI [0.07, 1.14]; p = 0.03), PPD reduction (WMD = 0.41 mm (95% CI [0.02, 0.80]; p = 0.04)) and BOP (WMD = −28.47% (95% CI [−33.00, −23.94]); p < 0.001), while for GI improvements were notable for >6 to 12 months (WMD = −0.27 (95% CI [−0.49, −0.06]; p = 0.01)). Conclusion Within the current review’s limitations, locally delivered antibiotics during surgical periodontal therapy results in post-surgical improvements for CAL, PPD, and BOP (≤6 months) with a longer-lasting GI improvement. Further randomized controlled trials are needed with true periodontal end-points to assess the ideal antibiotic agent, dosage, and delivery methods. Clinical relevance Local delivery of antibiotics during periodontal surgery improved clinical parameters for up to 6-month follow-up, with beneficial longer effects on gingival inflammation. Within the current study’s limitation, the presented evidence could support the elective usage of locally delivered antibiotics during surgical periodontal therapy. |
| Databáze: | OpenAIRE |
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