Locally-delivered antibiotics for management of periodontitis: current understanding

The primary etiology of periodontitis is bacterial plaque in a susceptible host. In an attempt to eradicate or reduce periopathogenic bacterial levels, locally-delivered antibiotic (LDA) agents have been suggested and have shown promising results. By applying the antibiotics locally, clinicians are able to overcome some of the disadvantages of systemic antibiotics in the management of periodontal patients. However, selecting a specific LDA to treat periodontitis out of the many available agents is not an easy task. Furthermore, timing of when to apply these agents can also be challenging. This literature review discusses the current understanding of the use of LDA in the management of periodontitis. A decision tree was developed in an attempt to guide the clinician in understanding the indications for the use of controlled delivery antimicrobial agents as an adjunct or alternative to traditional treatment modalities.