Role of antibiotics in generalized aggressive periodontitis: A review of clinical trials in humans

Abstract

Background:It is well-recognized fact that periodontal diseases are caused by multifactorial etiologies, in which microorganisms play an important role. An essential component of therapy is to eliminate or manage these pathogens. This has been traditionally accomplished through mechanical means by scaling and root planning which is ineffective in some of the aggressive periodontal diseases. These aggressive diseases involve particular groups of microorganisms which are not eliminated by mechanical means; and they require anti-infective therapy, which includes local and systemic antimicrobials. This approach of therapy is of interest to periodontist due to the aforementioned shortcomings of conventional methods.Materials and Methods:A manual and electronic search was made for human studies up to March 2011 that presented clinical and microbiological data for the efficacy of a systemic antibiotics in generalized aggressive periodontitis along with scaling and root planning. A systematic approach was followed by two independent reviewers and included eligibility criteria for study inclusion, quality assessment, and determination of outcome measures, data extraction, data synthesis, and drawing of conclusion.Results:Only three randomized controlled human trials qualified, and they concluded that both scaling and root planing (SRP) mono-therapy and SRP with antibiotics proves beneficial in improving clinical and microbiological parameters in aggressive periodontitis. Better results were seen in SRP with antibiotic groups as compared with SRP alone.Conclusion:Because of the insufficient quantity and heterogenecity of studies, no adequate evidence could be gathered to use the beneficial effects of these antibiotics along with SRP in aggressive periodontitis compared with SRP alone.

The Use of Polymerase Chain Reaction (PCR) for Indentifying Periodontopathogenic Bacteria - therapeutic Implications in Periodontal Disease

“…Benefits of systemic administration of antimicrobial agents as adjuvant to periodontal disease treatment have been reported by numerous researchers [27][28][29][30]. The choice of antibiotics should be made after determining the susceptibility, and their administration should follow the mechanical disruption of the plaque biofilm [31].…”

A Modern Approach to Treat Molar/Incisor Pattern Periodontitis—Review

“…In total, 74% of the pockets with PD ≥ 5 mm at baseline were 4 mm or shallower at 6 months in the test group, compared with 54% in the control group ( p = 0.008) [ 7 ]. Additional findings supporting the use of adjunctive antibiotics with initial phase therapy are abundant, but not all studies on the topic agree that the use of systemic antibiotics makes a significant difference [ 11 , 21 ]. Varela studied the effects of AMOX + MET+ SRP compared to SRP alone for patients with GAP and found that although both groups exhibited improved parameters such as PD reductions and increased CAL, there was not a significant difference between the two therapeutic groups at 6 months [ 15 ].…”

“…Antibiotics are routinely administered in conjunction with mechanical debridement to treat MIPP, effectively reducing the microbial load in periodontal pockets, particularly bacteria in the red complex and Aa [ 4 , 21 ]. Numerous studies have shown that adding antibiotics improves clinical parameters such as reduced probing depths, increased clinical attachment, and microbial population improvement in periodontal pockets [ 4 , 21 ]. The combination of AMOX + MET is the most extensively researched and evidence-based choice, with azithromycin as a viable alternative for penicillin-allergic individuals [ 9 ].…”

Advanced drug delivery approaches against periodontitis

“…However these procedures have some shortcomings like inability to reach the deep pockets and furcations (Herrera et al, 2012). Hence antimicrobials are administered along with these for complete cure of the ailment, particularly the aggressive periodontitis (Ahuja et al, 2012;Arweiler et al, 2014). The bacterial etiology of the infection should be considered before selecting an antibiotic.…”