Local delivery therapies as adjuvants to non-surgical periodontal treatment of periodontitis grade C: a systematic review

Gomes, Edvin Walter Brito; Casarin, Maísa; Martins, Thiago Marchi; Silva, Adriana Fernandes da

doi:10.1007/s00784-020-03631-8

Cited by 8 publications

(12 citation statements)

References 38 publications

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“…Another SR on local adjuvant therapies used to treat periodontitis Grade C severity found that simvastatin gel, alendronate gel and metronidazole gel showed some clinical benefits, but the the results were inconclusive and "off-label" products were included in the analysis [60]. Their clinical results differ from our previous [26] and current review as we segregated the analysis based on the frequency of LDA application as well as excluded discontinued and experimental adjuncts to cater to the current LDA market for the benefit of clinicians.…”

Section: Comparison Of Findings To Other Reviewsmentioning

confidence: 99%

Clinical Efficacy of Repeated Applications of Local Drug Delivery and Adjunctive Agents in Nonsurgical Periodontal Therapy: A Systematic Review

2021

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The aim of this systematic review is to compare the clinical efficacy of repeated applications of local drug delivery and adjunctive agents (LDAs) in nonsurgical periodontal therapy (NSPT) compared to subgingival mechanical debridement (SMD) alone. The Cochrane Central Register of Controlled Trials, MEDLINE, PubMed, EMBASE, Web of Science, hand-searched literature and grey literature databases were searched for randomized controlled clinical trials (RCTs) with a minimum of 6-month follow-up. The outcomes of interest were changes in probing pocket depth and clinical attachment level as well as patient-centred outcomes. Of 1094 studies identified, 16 RCTs were included in the qualitative analysis. Across 11 different adjuncts analysed, only two studies utilizing minocycline gel/ointment and antimicrobial photodynamic therapy (aPDT) with indocyanine green photosensitizer had statistically significant differences in primary outcomes when compared to their control groups. Only one study on aPDT methylene blue 0.005% had compared single versus multiple applications against its control group. A mean range of 0.27–3.82 mm PD reduction and −0.09–2.82 mm CAL gain were observed with repeated LDA application. Considerable clinical heterogeneity and methodological flaws in the included studies preclude any definitive conclusions regarding the clinical efficacy of repeated LDA applications. Future RCTs with a direct comparison between single and repeated applications should be conducted to confirm or refute the clinical advantages of repeated LDA application in the nonsurgical management of periodontitis.

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Section: Comparison Of Findings To Other Reviewsmentioning

confidence: 99%

Clinical Efficacy of Repeated Applications of Local Drug Delivery and Adjunctive Agents in Nonsurgical Periodontal Therapy: A Systematic Review

2021

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“…Metronidazole gel 25% showed a major decrease in the probing depth when compared with the control groups’ local therapies. 9 …”

Section: Introductionmentioning

confidence: 99%

Healing Enhancement Assessment of Thermosensitive in Situ Gelling Formulation Containing Metronidazole and Diclofenac Potassium for Ligature-induced Periodontitis in Rats

Wadi¹,

Ahuja²,

Peh³

2022

Oman Med J

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Objectives: We sought to investigate the healing efficacy of thermosensitive in situ gelling formulation containing metronidazole and diclofenac potassium on ligature-induced periodontitis (LIP) in rats. Methods: We used 30 adult male Sprague-Dawley rats; 24 rats were subjected to LIP, while the remaining six rats were used as control. The 24 rats with LIP were subdivided into four groups of six rats each. Group 1 received 5% metronidazole loaded gel, group 2 received 0.2% diclofenac potassium loaded gel, group 3 received 5% metronidazole and 0.2% diclofenac potassium, and group 4 (the control group) did not receive any treatment. Treatment was administered on day 0, and the rats were monitored over seven days. Specimens were collected for histological examination to assess the healing process. Results: We found a statistically significant difference (p < 0.050) in the inflammatory and repair parameters of the healing process between different treatments. Combining the two drugs significantly accelerated the healing compared to the drugs given alone. Conclusions: Using a combination of diclofenac and metronidazole could potentially accelerate the healing process compared to the use of a single drug of either diclofenac or metronidazole

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“…Treatment of periodontitis firstly aims to prevent further periodontal loss through severe reduction of local bacterial load [ 3 ] by professional subgingival instrumentation and patient-related approaches. By eliminating the infectious aetiology from the subgingival areas, subgingival instrumentation is considered the gold standard of periodontal therapy in all forms of periodontitis [ 4 ] and its clinical efficacy is well documented by previous or more recent systematic reviews [ 5 , 6 , 7 , 8 ]. Deep periodontal pockets or local anatomical risk factors such as furcation involvement or root concavities limit the access of professional subgingival instrumentation, thus, resulting in the persistence of the periodontal infection [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…Deep periodontal pockets or local anatomical risk factors such as furcation involvement or root concavities limit the access of professional subgingival instrumentation, thus, resulting in the persistence of the periodontal infection [ 9 ]. The use of locally delivered adjunctive products during subgingival instrumentation in periodontitis patients could improve clinical outcomes [ 5 , 7 ] as it has been shown that this therapy provides an antimicrobial effect [ 10 ] and facilitates the removal of subgingival deposits, dead tissue debris, and inflammatory exudates [ 11 , 12 ]. Nonetheless, the possible deleterious effects of the subgingival application of adjunctive antimicrobials on periodontal constituents also needs to be considered [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

“…Some commercial products based on chlorhexidine, doxycycline hyclate or minocycline gel [ 7 ], metronidazole gel [ 5 ], sodium hypochlorite [ 18 ], povidone iodine [ 19 ], silver nanospheres [ 20 ] or sulphonic acids [ 21 , 22 , 23 ] are currently being used in clinical practice as local adjunctive therapies to subgingival instrumentation mostly due to their antimicrobial effect. However, some drawbacks have been related to their use in terms of clinical performance [ 20 ] and biological effects [ 24 , 25 , 26 , 27 , 28 , 29 ].…”

Section: Introductionmentioning

confidence: 99%

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Cytotoxic Effects on Gingival Mesenchymal Stromal Cells and Root Surface Modifications Induced by Some Local Antimicrobial Products Used in Periodontitis Treatment

et al. 2021

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(1) Background: this study aims to test the cytotoxicity of three antimicrobial products used in periodontitis treatment on gingival mesenchymal stem cells (gMSCs) and their influence on root surfaces and gMSC adhesion. We tested the null hypothesis that the effects of the antimicrobials did not differ. (2) Methods: the commercial products based on sulphonic/sulphuric acids, sodium hypochlorite and silver nanoparticles, in five different concentrations, were added to culture medium for growing gMSCs. Cell proliferation capacity was tested using the Cell Counting Kit-8 (CCK8) and their viability was determined by succinate dehydrogenase activity (MTT) assay. Scanning electron microscopy evaluated the adhesion of gMSCs on root samples treated mechanically and with commercial products. (3) Results: the products induced a dose-dependent cytotoxicity in terms of reduced proliferation and viability of gMSCs, as well as cell shape modifications. Significant differences in CCK8 values between the different commercial products were observed. Based on proliferation tests, the null hypothesis was rejected. When MTT values of the three products were compared with each other, no significant differences were observed for any of the five concentrations (p = 0.065, p = 0.067, p = 0.172, p = 0.256, p = 0.060). (4) Conclusions: the three antimicrobials had a certain degree of cytotoxicity on gMSCs. gMSCs repopulated treated root surfaces.

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Local delivery therapies as adjuvants to non-surgical periodontal treatment of periodontitis grade C: a systematic review

Cited by 8 publications

References 38 publications

Clinical Efficacy of Repeated Applications of Local Drug Delivery and Adjunctive Agents in Nonsurgical Periodontal Therapy: A Systematic Review

Clinical Efficacy of Repeated Applications of Local Drug Delivery and Adjunctive Agents in Nonsurgical Periodontal Therapy: A Systematic Review

Healing Enhancement Assessment of Thermosensitive in Situ Gelling Formulation Containing Metronidazole and Diclofenac Potassium for Ligature-induced Periodontitis in Rats

Cytotoxic Effects on Gingival Mesenchymal Stromal Cells and Root Surface Modifications Induced by Some Local Antimicrobial Products Used in Periodontitis Treatment

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