Adjunctive Antimicrobials in Nonsurgical Periodontitis Treatment: A Review of Recent Trials and Indications

Authors: Boivin WG , Kormas I and Wolff LF

DOI: 10.23880/oajds-16000411

Volume 10, Issue 1

Abstract

This review collected the latest evidence from clinical trials on antimicrobials used as adjunctive medications for the mechanical management of periodontitis, a common condition affecting teeth that leads to tooth loosening and tooth loss. A search was conducted on PubMed in May 2024 to identify human clinical trial reports published in the last five years in English with a follow-up time of at least six months. This review included 29 randomized clinical trials. Nine trials studied the adjunctive use of systemic antibiotics, five investigated topical agents, and fifteen applied various antimicrobial photodynamic therapy (aPDT) protocols. The results of the included studies are discussed in the context of the latest evidencebased guidelines for the treatment of periodontitis. Adjunctive systemic antibiotics may benefit patients in selected severe periodontitis cases, providing clinical and subgingival microbiological improvements lasting more than six months when used with subgingival instrumentation. Localized treatment investigated in these studies demonstrated that aPDT and new locally delivered antimicrobials like ozone, 1% melatonin and 5% tea tree oil gel may provide benefits. Further research is needed to ensure more efficient uses for local delivery to provide a clinically significant improvement to the outcome of subgingival instrumentation in the treatment of periodontitis.

Keywords: Periodontal Disease; Periodontitis; Antimicrobial; Antibiotic; Oral Health; Non-Surgical Therapy

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