Mark-Steven Howe looks at a systematic review of the effectiveness of adjunctive antibiotics in smokers undergoing non-surgical periodontal treatment. While a statistical benefit was noted it was not considered to be clinically relevant.
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This reviews of the efficacy of periodontal maintenance treatment carried out in primary care compared to the specialist setting following specialist treatment included 8 cohort studies. The quality of the available evidence was limited suggesting outcomes may be poorer in primary care further high quality studies are required
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7 prospective cohort studies were included in this review of dental implant survival in patients with periodontitis. Patients with aggressive periodontitis has statistically significant lower survival rates at 3 years but the quality of the evidence is limited.
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4 small RCTs of probiotics as an adjunct to scaling and root planing for management of chronic periodontitis were identified for this review. While a statistical significant benefit was demonstrated the limited number of small studies means that these findings should be interpreted with caution.
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This review of the impact of furcation involvement on tooth loss in periodontal disease found 21 pro- and retrospective studies. The data suggests that the risk of tooth loss may be doubled where there is furcation involvement.
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13 small RCTs were identified for this review, comparing full mouth interventions with quadrant scaling for periodontitis. Limited evidence of a small benefit was found in two comparisons.
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Another new review of local or systemic azithromycin as an adjunct in non-surgical periodontal therapy includes 14 RCTs and demonstrates small benefits in periodontal parameters. However, the included studies are small and it is unclear if the benefits are clinically important.
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This review of azithromycin as an adjunct to scaling and root planing for periodontal disease included 9 small RCTs. While some studies demonstrated some small improvements in periodontal parameters, there was no data to demonstrate superiority of azithromycin against the standard antibiotic combination of metronidazole and amoxicillin.
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This review included 17 studies and 843 patients. A wide range of cytokines/chemokines were assessed but the available evidence is not sufficient to prove that there are distinct differences between patients with aggressive periodontitis and those with chronic periodontitis.
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This review compares the clinical outcomes of scaling and root planing with Er:YAG laser either as an alternative or as an adjuvant in patients with chronic periodontitis. 12 small trials were included and similar outcomes were seen with both treatments at 3 months . However hetrogeneity in teh studies and the small sample size mean that these finding should be interpreted with caution.
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