A systematic review on the effects of local antimicrobials as adjuncts to subgingival debridement, compared with subgingival debridement alone, in the treatment of chronic periodontitis.

@article{MatesanzPrez2013ASR,
  title={A systematic review on the effects of local antimicrobials as adjuncts to subgingival debridement, compared with subgingival debridement alone, in the treatment of chronic periodontitis.},
  author={Paula Matesanz-P{\'e}rez and Mar{\'i}a Garc{\'i}a-Gargallo and Elena Figuero and Antonio Bascones-Mart{\'i}nez and Mariano Sanz and David Herrera},
  journal={Journal of clinical periodontology},
  year={2013},
  volume={40 3},
  pages={
          227-41
        }
}
AIMS To update the existing scientific evidence on the efficacy of local antimicrobials as adjuncts to subgingival debridement in the treatment of chronic periodontitis. MATERIAL AND METHODS Fifty-six papers were selected, reporting data from 52 different investigations. All the studies reported changes in probing pocket depth (PPD) and clinical attachment level (CAL) and most in plaque index (PlI) and/or bleeding on probing (BOP). Meta-analyses were performed with the data retrieved from the… 
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Highly Influential Citations
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135 Citations

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Adjunctive effect of locally delivered antimicrobials in periodontitis therapy. A systematic review and meta-analysis.
TLDR
The use adjunctive locally delivered antimicrobials in periodontitis therapy results in statistically significant benefits in clinical outcomes, without relevant side effects.
Adjunctive subgingival application of Chlorhexidine gel in nonsurgical periodontal treatment for chronic periodontitis: a systematic review and meta-analysis
TLDR
Adjunctive subgingival administration of XAN-CHX gel at individual selected sites in N SPT appears to provide slight benefits in PPD reduction compared to NSPT alone for CP.
Effect of chlorhexidine chip as an adjunct in non-surgical management of periodontal pockets: a meta-analysis
TLDR
SRP with adjunctive CHX chips showed better clinical outcomes than SRP alone for the management of periodontal pockets in patients with chronic periodontitis.
Efficacy of Local Antimicrobials in the Non-Surgical Treatment of Patients With Periodontitis and Diabetes: A Systematic Review.
TLDR
In patients with DM and CP, use of local antimicrobials as an adjunct to SRP may result in additional benefits compared with SRP alone in PD reduction and CAL gain, especially in well-controlled individuals and deep sites.
Clinical Efficacy of Repeated Applications of Local Drug Delivery and Adjunctive Agents in Nonsurgical Periodontal Therapy: A Systematic Review
TLDR
Across 11 different adjuncts analysed, only two studies utilizing minocycline gel/ointment and antimicrobial photodynamic therapy (aPDT) with indocyanine green photosensitizer had statistically significant differences in primary outcomes when compared to their control groups.
A Comparative Clinical Evaluation of Subgingivally Delivered 0.5% Azithromycin Gel and 2 mg Tetracycline Hydrochloride Fibers as an Adjunct to Scaling and Root Planing in the Treatment of Chronic Periodontitis
TLDR
All the three modalities of treatment were efficient in improving the clinical parameters and there was no statistically significant difference between AZM & Tetracycline group.
Effect of Subgingivally Delivered 10% Emblica officinalis Gel as an Adjunct to Scaling and Root Planing in the Treatment of Chronic Periodontitis – A Randomized Placebo‐controlled Clinical Trial
TLDR
E. officinalis sustained‐release gel used as an adjunct to SRP may be more effective in reducing inflammation and periodontal destruction in patients with chronic periodontitis when compared with SRP alone.
Clinical efficacy of subgingivally delivered propolis as an adjuvant to nonsurgical periodontal treatment of periodontitis: A systematic review and meta‐analysis
TLDR
The adjunctive use of locally delivered propolis associated to N SPT to treat periodontitis may improve periodontal clinical parameters, compared with NSPT alone/placebo, but the evidence was not strong enough to safely base any clinical recommendation.
Adjunctive local treatments for patients with residual pockets during supportive periodontal care: A systematic review and network meta-analysis.
TLDR
Adjunctive local antimicrobial agents achieved small additional PPD reduction and CAL gain in residual pockets for a follow-up of up to 6 months.
Clinical and microbiological effects of adjunctive local delivery of minocycline (Periocline®) in patients receiving supportive periodontal therapy: a pilot study
TLDR
Mechanical debridement in patients receiving maintenance therapy resulted in clinically significant improvement; the effectiveness of additional local delivery of antibiotics was not significant.
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References

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TLDR
The adjunctive use of the CHX chip resulted in a significant PD reduction and a clinical attachment gain compared to SRP alone and was concomitant with a significant benefit of SRP + CHX treatment on the subgingival microbiota.
Clinical and Microbiologic Effects of Subgingival Controlled-Release Delivery of Chlorhexidine Chip in the Treatment of Periodontitis: A Multicenter Study
TLDR
The aim of this study was to provide further data on the clinical and microbiologic effects of CHX chips when used as an adjunct to SRP.
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TLDR
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TLDR
A large number of studies have indicated significantly higher pocket reductions and clinical attachment gains following a combination of mechanical debridement and repeated chlorhexidine chip administration in comparison to scaling and root planing alone, however, some recent studies failed to con...
Clinical and microbiologic effects of subgingivally delivered 0.5% azithromycin in the treatment of chronic periodontitis.
TLDR
Although both treatment strategies seemed to benefit the patients, the adjunctive use of 0.5% AZM as a controlled drug-delivery system enhanced the clinical and microbiologic results as shown by the intergroup comparison.
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TLDR
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TLDR
SRP plus TE fibres gave the greatest advantage in the treatment of periodontal persistent lesions at least 12 months following treatment.
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TLDR
The CHX chip did not provide any clinical or microbiological benefit beyond that achieved with conventional scaling and root planning, after a 9-month period.
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TLDR
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