Systemic antibiotics in the treatment of aggressive periodontitis. A systematic review and a bayesian network meta-analysis
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Fecha
2015
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Publicado en
Journal of Clinical Periodontology, 0303-6979, Vol. 42, Nro. 7, 2015, p. 647-657
Publicado por
Wiley
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Resumen
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Abstract
Aim: The aim of this study was to assess the effect of systemic antibiotic therapy
on the treatment of aggressive periodontitis (AgP).
Methods: This study was conducted and reported in accordance with the PRISMA statement. The MEDLINE, EMBASE and CENTRAL databases were
searched up to June 2014 for randomized clinical trials comparing the treatment
of subjects with AgP with either scaling and root planing (SRP) alone or
associated with systemic antibiotics. Bayesian network meta-analysis was
prepared using the Bayesian random-effects hierarchical models and the outcomes
reported at 6-month post-treatment.
Results: Out of 350 papers identified, 14 studies were eligible. Greater gain in
clinical attachment (CA) (mean difference [MD]: 1.08 mm; p < 0.0001) and reduction in probing depth (PD) (MD: 1.05 mm; p < 0.00001) were observed for
SRP + metronidazole (Mtz), and for SRP + Mtz + amoxicillin (Amx) (MD:
0.45 mm, MD: 0.53 mm, respectively; p < 0.00001) than SRP alone/placebo.
Bayesian network meta-analysis showed additional benefits in CA gain and PD
reduction when SRP was associated with systemic antibiotics.
Conclusions: SRP plus systemic antibiotics led to an additional clinical effect
compared with SRP alone in the treatment of AgP. Of the antibiotic protocols
available for inclusion into the Bayesian network meta-analysis, Mtz and Mtz/
Amx provided to the most beneficial outcomes.
Palabras clave
Keywords
Aggressive periodontitis, Amoxicillin, Anti-infective agents, Metronidazole, Root planing, Systematic review