Adjunctive Drug-Loaded Gel Application in the Treatment of Periodontitis: A Systematic Evaluation and Meta-Analysis

Abstract

Background This meta-analysis aimed to assess and systematically investigate the efficacy of drug-loaded gel adjuncts in the treatment of periodontitis based on relevant literature. Methods Six databases including the China National Knowledge Infrastructure, WanFang Data, VIP Chinese Science and Technology Periodical Database, China Biology Medicine disc, Cochrane library, PubMed, and Web of Science were searched from the establishment of the database until December 2021 for randomized controlled trials (RCTs) that studied the application of drug-loaded gel in periodontitis treatment. The meta-analysis was conducted using Stata 15.0 and Review Manager 5.4 for articles that met the criteria. Results The study included nine RCTs involving 706 participants. Periodontal probing depth (PPD) and clinical attachment level (CAL) were the primary and secondary outcomes, respectively. The subgroup analyses performed for PPD (standardized mean difference [SMD] = 0.59, 95% confidence interval [CI]=[0.44, 0.73], I2 = 48.0%, p = 0.05) and CAL (SMD = 0.58, 95% CI=[0.34, 0.82], I2 = 61.0%, p = 0.005) of follow-up period revealed that the heterogeneity (p) among groups of each indicator is 0.98 and 0.96, respectively. The gel component was analyzed as another subgroup factor, reflected by heterogeneity (p = 0.23) among groups and Egger test (p = 0.794) in PPD, while the results of those in CAL were 0.1 and 0.079, respectively. Conclusion The application of drug-loaded gel as an adjunctive therapy for periodontitis resulted in effectively reduced PPD and promoted CAL recovery, providing an evidence-based improvement in efficacy, security, and rational use for clinical drug therapy instruction for periodontitis.