Periodontal treatment to prevent or manage cardiovascular disease

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Two small RCTs at high risk of bias were included in this Cochrane systematic review looking at the effects of periodontal therapy for primary or secondary prevention of CVD in people with chronic periodontitis.

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Non-surgical periodontal therapy – which antibiotic regime?

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This review of amoxicillin & metronidazole as an adjunct to non-surgical periodontal treatment included 18 trials . A small benefit was seen with antibiotic use but no clinically meaningful difference between different doses or duration of amoxicillin-plus-metronidazole at 3 months post-treatment.

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Third molar removal: antibiotics reduced risk of dry socket

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This review of antibiotic prophylaxis for the removal of third molars included 22 RCTs and suggest that antibiotic use lowered the infection risk by 60%. The number pf patients needed to treat to prevent one infection was 14 (95%CI;11-19).

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Periodontal treatment- adjuvant antibiotics for diabetic patients?

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This review of adjuvant antibiotics for diabetics undergoing periodontal treatment included 13 small RCTs. While a statistically significant improvement in probing depth was seen the magnitude of this improvement is unlikely to be clinically significant.

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Amoxicillin and metronidazole as an adjunct to scaling and root planning for periodontitis?

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This review of the adjunctive use of amoxicillin and metronidazole with scaling and root planing for the management of periodontitis found improved clinical outcomes in terms of pocket depth and clinical attachment level with their use.

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Third molars: single dose of preoperative antibiotic reduced infection

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10 RCTs were included in this review of preoperative antibiotics for removal of third molars. The use of antibiotics significantly reduced the odds of surgical site infection or alveolar osteitis (OR = 0.30; 95% CI, 0.19 to 0.47; P≤.00001)

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Systemic antibiotics for aggressive periodontitis?

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This review of systemic antibiotics and non-surgical periodontal therapy for aggressive periodontitis included 13 RCTs and suggests a statistically significant benefit compared to non-surgical therapy alone.

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Aggressive periodontitis: systemic antibiotics may improve outcome

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This review and network meta-analysis included 11 small RCTs of limited quality, suggesting a statistically significant benefit for the use of adjunctive systemic antibiotics for the treatment of aggressive periodontitis.

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Non-surgical periodontal treatment – is there a role for systemic antibiotics?

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This review update includes 23 new studies comparing the effects of antibiotic therapy adjunctive to scaling and root planning for periodontal disease. While some additional benefit was shown the authors could not establish definitive conclusions and guidelines regarding their use.

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ADA-EBD summary on amoxicillin/metronidazole therapy for aggressive periodontitis

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This ADA-EBD critical summary looks at a systematic review from the same group that conducted the review that we highlighted yesterday (Sgolastra et al 2012).  This time the question was whether the use of amoxicillin/metronidazole (AMX/MET) as an adjunct to scaling and root planning (SRP) was more effective than SRP alone in the treatment of [read the full story…]