Adjunctive local treatments for patients with residual pockets during supportive periodontal care: A systematic review and network meta-analysis
Journal
Journal of Clinical Periodontology
Journal Volume
47
Journal Issue
12
Pages
1496-1510
Date Issued
2020
Author(s)
Abstract
Aim: This systematic review and network meta-analysis aimed to evaluate the efficacy of adjunctive locally delivered antimicrobials, compared to subgingival instrumentation alone or plus a placebo, on changes in probing pocket depth (PPD) and clinical attachment level (CAL), in patients with residual pockets during supportive periodontal care. Materials and methods: Literature search was performed with electronic databases and by hand until 31 May 2020. Primary outcome was the changes in PPD. The treatment effects between groups were estimated with weighted mean differences (WMD) with 95% confidence intervals (CI) and prediction intervals (PI) by using random-effects network meta-analysis. Results: Twenty-two studies were included. Significantly greater PPD reduction was achieved in chlorhexidine chip group (WMD: 0.65?mm, 95% CI: 0.21–1.10) and tetracycline fibre group (WMD: 0.64?mm, 95% CI: 0.20–1.08) over 6-month follow-up. Other adjunctive antimicrobial agents achieved non-significant improvements compared to scaling and root planing alone. All differences between adjunctive therapies were statistically non-significant. Similar findings were observed for CAL gain. Conclusion: Adjunctive local antimicrobial agents achieved small additional PPD reduction and CAL gain in residual pockets for a follow-up of up to 6?months. Tetracycline fibre and chlorhexidine chip achieved better results than other antimicrobials. ? 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
SDGs
Other Subjects
chlorhexidine; doxorubicin; doxycycline; metronidazole; minocycline; photosensitizing agent; tetracycline; antiinfective agent; chlorhexidine; antibiotic resistance; chronic periodontitis; clinical outcome; debridement; drug efficacy; enamel; human; interrater reliability; Lactobacillus casei; meta analysis; outcome assessment; periodontal disease; periodontal pocket; photochemotherapy; plaque index; Porphyromonas gingivalis; postoperative pain; prevalence; quality of life; randomized controlled trial (topic); Review; root planing; spondylolisthesis; systematic review; tooth extraction; dental scaling; network meta-analysis; Anti-Bacterial Agents; Chlorhexidine; Dental Scaling; Humans; Network Meta-Analysis; Root Planing
Publisher
Blackwell Munksgaard
Type
review