Antibiotics as adjunct to non-surgical periodontal therapy in diabetic patients

Q3 Dentistry Evidence-based dentistry Pub Date : 2024-11-15 DOI:10.1038/s41432-024-01085-5
Lata Goyal, Shipra Gupta, Yeshwanth Perambudhuru
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Abstract

A comprehensive literature search was performed via MEDLINE/PubMed, Scopus, and Web of Science, including all relevant publications accessed on March 2023 and subsequently updated up to July 2024. Additionally, grey literature was searched, and there was no restriction on publication data and languages. All randomized clinical trials comparing topical/systemic antibiotics as an adjunct to scaling and root planning (SRP) with SRP alone for the treatment of diabetic patients with periodontitis were included. Literature reviews, case reports and series, preclinical studies or studies lacking periodontal data were excluded. Clinical attachment level was considered as the primary outcome. Bleeding on probing, pocket depth, and gingival index were the secondary outcomes. The risk of bias was evaluated using the Cochrane Collaboration Tool, and for each domain, bias risk was judged as low, unclear and high risk of bias. Selection, removing duplicates, screening, extracting data, and assessing the quality of studies were done by two investigators and findings were tabulated. Meta-analysis was conducted, generating forest plots to compare different treatment modalities, time periods, and antibiotic types. Key periodontal parameters such as probing pocket depth (PPD), clinical attachment level (CAL), plaque index (PI), and bleeding on probing (BoP) were analysed. Upon screening and further evaluation of 690 articles, 43 were considered for full-text eligibility. Finally, 30 studies were included in the systematic review, and 27 were included in meta-analysis. Out of 30 randomized clinical trials, 9 studies focused on topical and antibiotics, and 21 involved systemic administration of antibiotics. Five of the nine studies focussing on topical administration of antibiotics, were classified as having a low risk of bias and four as having a high risk of bias. Out of 21 studies on systemic antibiotics, eight were classified as having a low risk of bias, two were undefined, and eleven showed a high risk of bias. Authors concluded that adjunctive use of antibiotics could lead to improvement in periodontal clinical parameters The findings showed that the adjunctive use of antibiotics led to slight improvements in clinical outcomes. However, keeping in mind antibiotic resistance, and side effects of antibiotics, their use should be approached cautiously and only when necessary.
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抗生素作为糖尿病患者非手术牙周治疗的辅助手段。
数据来源:通过MEDLINE/PubMed、Scopus和Web of Science进行了全面的文献检索,包括2023年3月访问的所有相关出版物,以及随后更新至2024年7月的所有相关出版物。此外,还检索了灰色文献,对出版数据和语言没有限制:所有随机临床试验均被纳入,这些试验比较了局部/全身抗生素作为洗牙和根面规划(SRP)的辅助手段与单独使用SRP治疗糖尿病牙周炎患者的效果。文献综述、病例报告和系列研究、临床前研究或缺乏牙周数据的研究均被排除在外。临床附着水平被视为主要结果。数据提取与综合:使用 Cochrane 协作工具对偏倚风险进行评估,每个领域的偏倚风险分为低偏倚风险、不明确偏倚风险和高偏倚风险。选择、删除重复、筛选、提取数据和评估研究质量的工作由两名研究人员完成,并将结果制成表格。进行了元分析,生成森林图来比较不同的治疗方式、时间段和抗生素类型。对探诊袋深度(PPD)、临床附着水平(CAL)、菌斑指数(PI)和探诊出血(BoP)等关键牙周参数进行了分析:经过对 690 篇文章的筛选和进一步评估,43 篇文章被认为符合全文资格。最后,30 项研究被纳入系统综述,27 项研究被纳入荟萃分析。在 30 项随机临床试验中,9 项研究侧重于局部使用抗生素,21 项研究涉及全身使用抗生素。9 项研究中,5 项侧重于局部使用抗生素,被归类为偏倚风险较低,4 项偏倚风险较高。在 21 项关于全身使用抗生素的研究中,有 8 项研究的偏倚风险较低,2 项研究的偏倚风险未确定,11 项研究的偏倚风险较高。作者认为,辅助使用抗生素可改善牙周临床参数 结论:研究结果表明,辅助使用抗生素可略微改善临床结果。然而,考虑到抗生素的耐药性和副作用,只有在必要时才应谨慎使用抗生素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Evidence-based dentistry
Evidence-based dentistry Dentistry-Dentistry (all)
CiteScore
2.50
自引率
0.00%
发文量
77
期刊介绍: Evidence-Based Dentistry delivers the best available evidence on the latest developments in oral health. We evaluate the evidence and provide guidance concerning the value of the author''s conclusions. We keep dentistry up to date with new approaches, exploring a wide range of the latest developments through an accessible expert commentary. Original papers and relevant publications are condensed into digestible summaries, drawing attention to the current methods and findings. We are a central resource for the most cutting edge and relevant issues concerning the evidence-based approach in dentistry today. Evidence-Based Dentistry is published by Springer Nature on behalf of the British Dental Association.
期刊最新文献
Do antibiotics prior to dental extractions reduce adverse post-operative outcomes? Comparative evaluation of pit & fissure sealant retention using cotton roll & rubber dam isolation techniques - a systematic review & meta-analysis. Soft and hard tissue changes following immediate implant placement and immediate loading in aesthetic zone-a systematic review and meta-analysis. Effectiveness of photobiomodulation with low-level lasers on the acceleration of orthodontic tooth movement: an umbrella review. Applications of AI-based deep learning models for detecting dental caries on intraoral images - a systematic review.
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