Systemic antimicrobials adjuvant to periodontal therapy in diabetic subjects: a meta-analysis.
BACKGROUND
Adjuvant antibiotics have been suggested to improve periodontal therapy in diabetic subjects.


AIM
The aim of this study was to systematically review randomized clinical trials assessing systemic antimicrobial use adjuvant to scaling and root planing (SRP) versus SRP alone in diabetic subjects.


MATERIAL AND METHODS
The PubMed, Cochrane Central Register of Controlled Trials, EMBASE, TRIP, Web of Science and LILACS databases and the grey literature were searched through May 2015. Of 2534 potentially eligible studies, 13 were included in the systematic review. Weighted mean differences (WMDs) in probing depth (PD) reduction and clinical attachment level (CAL) gain (primary outcomes), and plaque index (PI) and bleeding on probing (BOP) reductions, were estimated using a random effect model.


RESULTS
The WMD in PD reduction [-0.15 mm, n = 11, p = 0.001, 95% confidence interval (CI) -0.24, -0.06] favoured antibiotic use. WMDs in CAL gain, PI and BOP reductions (-0.14 mm, n = 9, p = 0.11, 95% CI -0.32, 0.03; 4.01%, n = 7, p = 0.05, 95% CI -0.04, 8.07; and -1.91%, n = 7, p = 0.39, 95% CI -6.32, 2.51 respectively) did not favour adjunctive antibiotic use.


CONCLUSION
Adjunctive therapy may improve the efficacy of SRP in reducing PD in diabetic subjects.
['Grellmann|Alessandra Pascotini|AP|', 'Sfreddo|Camila Silveira|CS|', 'Maier|Juliana|J|', 'Lenzi|Tathiane Larissa|TL|', 'Zanatta|Fabricio Batistin|FB|']
D000328:Adult D000368:Aged D000900:Anti-Bacterial Agents D000890:Anti-Infective Agents D012534:Dental Scaling D003920:Diabetes Mellitus D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D017622:Periodontal Attachment Loss D010512:Periodontal Index D010514:Periodontal Pocket D016745:Root Planing
periodontal therapy antibiotic amoxicillin azithromycin chronic periodontitis clavulanic acid diabetes mellitus doxycycline metronidazole periodontal disease