Chronic periodontitis: Efficacy of adjunctive antimicrobials

Many drugs are licensed for use in Generalised Anxiety Disorder (GAD), but it is unclear what works best.

This review of the efficacy of antimicrobials adjunctive to scaling and root planing (SRP) in the treatment of chronic periodontitis. 21 RCTs were included with the findings showing that amoxicillin and metronidazole had the largest statistical benefit. Whether this benefit is a clinically important benefit is a wider question.

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Diabetes and dental implants

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This review of the possible association between diabetes mellitus and dental implant complications included 10 cohort studies (8 prospective 2 retrospective). The findings suggest that patients with diabetes are more likely to have clinical complications with dental implants.

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Boric acid as an adjunct to non-surgical periodontal therapy?

gum disease, scale and polish

Non-surgical periodontal treatment is the mainstay of treatment for the management of periodontitis. A number of adjunctive treatments have been used to improve outcomes including, local and systematic antibiotics and photodynamic therapy.  It has been suggested that boric acid may be beneficial as boron compounds have antimicrobial, anti-inflammatory and immune regulatory effects and beneficial effects [read the full story…]

Top Dental Elf Blogs: Jul – Sep 2020

The Dental Elf

Our most popular blogs in July August and September covered periodontal surgery, Interproximal caries detection and local anaesthesia for inferior alveolar nerve blocks.

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Access flap procedures or subgingival debridement for periodontitis?

Periodontal disease
Periodontitis

This review comparing access flaps (AF) and subgingival debridement in achieving probing depth (PD) reduction in patients with periodontitis included 18 studies reported in 36 publications. While the results demonstrated a statistically significant improvement in PD reduction between AF and subgingival debridement this may not be clinically important.

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Smoking and its impact on non-surgical periodontal therapy

gum disease, scale and polish

This review of the impact of smoking on clinical outcomes of non-surgical periodontal treatment included 17 cohort studies of whihc 11 were prospective. The findings suggest statistically significant smaller improvements in the smoking that non-smoking group. However, any differences are modest and my not be clinically important.

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Photodynamic therapy as an adjunct to non-surgical periodontal treatment

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This review of the adjunctive effects of lasers or antimicrobial photodynamic therapy (aPDT) to non-surgical periodontal treatment included 17 RCTs. The studies were small and hetrogeneous including just 701 patients in total and of low quality providing very limited evidence.

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Periodontitis: Locally delivered antimicrobials as an adjunct to non-surgical treatment

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This review of of locally delivered antimicrobials as an adjunct to scaling and root planing (SRP) for the non-surgical treatment of patients with periodontitis included 50 RCTs. While the findings indicate statistically significant benefits for probing pocket depth and clinical attachment level (CAL) at 6-9 months and for CAL at 12-60 months their clinical importance can be questioned. In addition most of the studies(47) were considered to be at high risk of bias.

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Periodontitis: Systemic antimicrobials as an adjunct to non-surgical treatment

Periodontal disease
Periodontitis

This Cochrane review of the effects of systemic antimicrobials as an adjunct to scaling and root planing (SRP) for the non-surgical treatment of patients with periodontitis identified 45 RCTs. However the evidence is of very low certainty to inform tclinicians and patients if adjunctive antibiotics are beneficial.

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Chlorhexidine chip as adjunct to scaling and root planing in patients with chronic periodontitis

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This review of sub-gingival chlorhexidine chips as an adjunct to scaling and root planing in patients with chronic periodontitis included 15 RCTs involving 620 patients in total. Findings suggest an additional improvement with adjunctive use of chlorhexidine chips.

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