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Local delivery therapies as adjuvants to non-surgical periodontal treatment of periodontitis grade C: a systematic review

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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).

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Authors and Affiliations

  1. Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil

    Edvin Walter Brito Gomes, Maísa Casarin & Adriana Fernandes da Silva

  2. Department of Semiology and Clinic, School of Dental Medicine, Federal University of Pelotas, Pelotas, Brazil

    Maísa Casarin & Thiago Marchi Martins

Authors
  1. Edvin Walter Brito Gomes
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  2. Maísa Casarin
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  4. Adriana Fernandes da Silva
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Contributions

All authors contributed to the study conception and design. The conception was performed by Adriana Fernandes da Silva. Material preparation and data collection and analysis were performed by Edvin Walter Brito Gomes, Maísa Casarin, and Thiago Marchi Martins. The first draft of the manuscript was written by Edvin Walter Brito Gomes and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Adriana Fernandes da Silva.

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Gomes, E.W.B., Casarin, M., Martins, T.M. et al. Local delivery therapies as adjuvants to non-surgical periodontal treatment of periodontitis grade C: a systematic review. Clin Oral Invest 24, 4213–4224 (2020). https://doi.org/10.1007/s00784-020-03631-8

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