Local delivery therapies as adjuvants to non-surgical periodontal treatment of periodontitis grade C: a systematic revie
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REVIEW
Local delivery therapies as adjuvants to non-surgical periodontal treatment of periodontitis grade C: a systematic review Edvin Walter Brito Gomes 1 & Maísa Casarin 1,2 & Thiago Marchi Martins 2 & Adriana Fernandes da Silva 1 Received: 30 April 2020 / Accepted: 7 October 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objectives The aim of this article was to perform a systematic review on the effectiveness of local adjuvant therapies in the treatment of aggressive periodontitis (AgP), now reported as periodontitis grade C. Materials and methods The authors selected randomized clinical trials of AgP patients who received local therapy as adjuvants to non-surgical periodontal with a duration of at least 90 days. Seven databases were searched up to January 2020. The gain in clinical attachment level (CAL) and reduction of probing depth (PD) were the outcomes of interest. Results Of the 3583 studies found, only five articles were included in the qualitative analysis. Among the substances analyzed, only 1.2 mg of simvastatin gel (SMV) (1.2 mg/0.1 ml), 1% of alendronate gel (ALN) (10 mg/ml), and 25% metronidazole gel (MTZ) (Elyzol@) showed a significant decrease in the probing depth when compared with their respective control groups. The gain CAL was shown using 1.2 mg SMV gel (1.2 mg/0.1 ml) and 1% ALN gel (10 mg/ml). Conclusion Although 1.2 mg SMV gel (1.2 mg/0.1 ml), 1% ALN gel (10 mg/ml), and 25% MTZ gel (Elyzol) have shown better results, local therapies adjuvant to SRP the data found were limited. Future clinical studies with appreciable methodological quality should be conducted. Clinical relevance Despite some benefits of local delivery therapy, up to now, it has not been possible to prove the efficacy of local therapy as an adjunct to standard treatment of AgP (periodontitis grade C). Keywords Periodontal diseases . Aggressive periodontitis . Root planning . Therapeutic irrigation
Introduction Inflammatory and immune reactions in the periodontal tissues are induced by dental biofilm and microorganisms capable of damaging the connective tissue and alveolar bone [1]. Aggressive periodontitis (AgP), similar to periodontitis grade C, is characterized by early onset, rapid progression, with high
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00784-020-03631-8) contains supplementary material, which is available to authorized users. * Adriana Fernandes da Silva [email protected] 1
Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
2
Department of Semiology and Clinic, School of Dental Medicine, Federal University of Pelotas, Pelotas, Brazil
risk of tooth loss at a young age [2, 3]. The prevalence of chronic periodontitis ranges from 40 to 80% while the prevalence of AgP showed a variation from 0.3 to 4.5%, with the localized form being less prevalent [4]. According to the current classification of periodontal diseases [3], three forms of periodontitis can be identified: necrotizing periodontitis,
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