The concomitant administration of systemic amoxicillin and metronidazole compared to scaling and root planing alone in treating periodontitis: =a systematic review=

BMC Oral Health

Research Article

Dina Zandbergen¹  Dagmar Else Slot¹  Fridus A. Van der Weijden²  Richard Niederman³ 

[1] Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Gustav Mahlerlaan 3004, 1081, Amsterdam, LA, The Netherlands;Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Gustav Mahlerlaan 3004, 1081, Amsterdam, LA, The Netherlands;Clinic for Periodontology, Livingstonelaan 466, 3526 JB, Utrecht, The Netherlands;College of Dentistry, New York University, 345 E. 24th Street, 10010, New York, NY, USA;

关键词: Periodontal therapy;    Scaling and root planning;    Systemic antibiotics;    Amoxicillin;    Metronidazole;    Periodontitis;    Antimicrobial drug;    Non-surgical periodontal therapy;    Systematic review;    Evidence based dentistry;   

DOI  :  10.1186/s12903-015-0123-6

 received in 2015-04-09, accepted in 2015-10-19,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThe treatment of periodontitis begins with a non-surgical phase that includes scaling and root planing(SRP) and on occasion the use of systemic antibiotics. The goal was to systematically evaluate in systemic healthy adults the effect of the concomitant administration of amoxicillin (amx) and metronidazole (met) adjunctive to SRP compared to SRP alone.MethodsThe PubMed-MEDLINE, Cochrane-CENTRAL and EMBASE databases were searched up to November 2014 to identify appropriate studies. Probing Pocket Depth (PD), Clinical Attachment Level (CAL), Bleeding on Pocket Probing(BOP) and Plaque Indices(PI) were selected as outcome variables. Based on the extracted data a meta-analysis was conducted.ResultsA total of 526 unique articles were found, 20 studies met the eligibility criteria. A meta-analysis showed that SRP + amx + met provided significantly better effects overall and more pronounced PD reduction in periodontal pockets initially measuring ≥6 mm (DiffM:-0.86 mm, p < 0.00001) and gain in CAL(DiffM:+0.75 mm, p = 0.0001). The meta-analysis for the secondary inflammatory parameter BOP showed that SRP + amx + met provided full mouth significantly greater reduction in BOP than SRP alone (DiffM:-6.98 %, p = 0.0001).ConclusionAdjunctive systemic amoxicillin and metronidazole medication to SRP significantly improved the clinical outcomes with respect to mean PD, CAL and BOP compared to SRP alone. There is moderate to strong evidence in support of the recommendation that adjunctive amx + met therapy to SRP significantly improves the clinical outcomes, with respect to mean PD and CAL compared to SRP alone especially in initially deep (≥6 mm) pockets. No major side effects associated with the intake of amx + met were reported. This treatment regimen is an efficacious, minimally invasive, practical and inexpensive approach for periodontitis therapy. The key components are mechanical tooth and pocket debridement, supportive treatment of the disease with systemic antibiotics and attention to proper self-care.

【 授权许可】

CC BY   
© Zandbergen et al. 2016