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Systemic Antibiotics as an Adjunct to Subgingival Debridement: A Network Meta-Analysis
Ainol Haniza Kherul Anuwar1, Roslan Saub1, Syarida Hasnur Safii2
1Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur 50603, Malaysia.
Antibiotics (Basel, Switzerland)
|December 23, 2022
Summary
Systemic antibiotics like satranidazole, metronidazole, and clindamycin may improve periodontal health when used with subgingival debridement. However, evidence certainty varies, necessitating cautious interpretation and careful consideration of potential harm from antibiotic overuse.
Area of Science:
- Periodontology
- Pharmacology
- Evidence Synthesis
Background:
- Periodontitis is a prevalent inflammatory condition affecting tooth-supporting structures.
- Subgingival debridement is a cornerstone of periodontitis treatment.
- The adjunctive role of systemic antibiotics requires robust evaluation.
Purpose of the Study:
- To evaluate the efficacy of systemic antibiotics as an adjunct to subgingival debridement in periodontitis patients.
- To compare the effectiveness of different antibiotic regimens through network meta-analysis.
- To assess improvements in clinical attachment level, probing depth, and bleeding on probing.
Main Methods:
- Systematic review and frequentist random-effects network meta-analysis.
- Inclusion of 30 randomized controlled trials.
- Reporting of mean differences with 95% confidence intervals and P-score rankings.
Main Results:
- Minimally important clinical differences observed for satranidazole, metronidazole, and clindamycin in clinical attachment gain and probing depth reduction.
- Metronidazole and amoxicillin-metronidazole combination showed minimally important differences in bleeding on probing reduction.
- Evidence certainty ranged from very low to high, indicating potential variability in findings.
Conclusions:
- Adjunctive systemic antibiotics may offer clinical benefits in periodontitis treatment.
- Findings should be interpreted cautiously due to variable evidence certainty.
- Balancing benefits against potential harm, including antibiotic overuse, is crucial.
