A systematic review on the effects of local antimicrobials as adjuncts to subgingival debridement, compared with subgingival debridement alone, in the treatment of chronic periodontitis.

AIMS: To update the existing scientific evidence on the efficacy of local antimicrobials as adjuncts to subgingival debridement in the treatment of chronic periodontitis. MATERIAL AND METHODS: Fifty-six papers were selected, reporting data from 52 different investigations. All the studies reported changes in probing pocket depth (PPD) and clinical attachment level (CAL) and most in plaque index (PlI) and/or bleeding on probing (BOP). Meta-analyses were performed with the data retrieved from the studies fulfilling the inclusion criteria. RESULTS: The overall effect of the subgingival application of antimicrobials was statistically significant (p = 0.000) for both changes in PPD and CAL with a weighted mean difference (WMD) of -0.407 and -0.310 mm respectively. No significant differences occurred for changes in BOP and PlI. Subgingival application of tetracycline fibres, sustained released doxycycline and minocycline demonstrated a significant benefit in PPD reduction (WMD between 0.5 and 0.7 mm). The rest of the tested outcomes demonstrated a high heterogeneity. The local application of chlorhexidine and metronidazole showed a minimal effect when compared with placebo (WMD between 0.1 and 0.4 mm). CONCLUSIONS: The scientific evidence supports the adjunctive use of local antimicrobials to debridement in deep or recurrent periodontal sites, mostly when using vehicles with proven sustained release of the antimicrobial.

Periodontal disease and diabetes-Review of the literature

Aims: To provide updated knowledge on the relationship between periodontal disease and diabetes from an oralhealth perspective.Methods: A review of the English-language literature was performed, gathering articles on the two diseases publishedover the past 10 years.Results: Both diseases result from the confluence of various triggering and modifying factors, and there are interindividualdifferences in the risk of their development. Recent research has shown that diabetes may increase therisk of periodontitis, and it has been proposed that chronic periodontal disease may influence the natural course ofdiabetes. There appears to be an association among oral infections, impaired sugar metabolism, and atherosclerosis,indicating a theoretical link between metabolic syndrome and periodontal disease.Clinical implications Control of periodontal disease may enhance glycemic control in patients with type 2 diabetes.In turn, improved glycemic control may contribute to a better control of periodontal disease (AU)

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Periodontal disease and diabetes-Review of the Literature.

AIMS: To provide updated knowledge on the relationship between periodontal disease and diabetes from an oral health perspective. METHODS: A review of the English-language literature was performed, gathering articles on the two diseases published over the past 10 years. RESULTS: Both diseases result from the confluence of various triggering and modifying factors, and there are inter-individual differences in the risk of their development. Recent research has shown that diabetes may increase the risk of periodontitis, and it has been proposed that chronic periodontal disease may influence the natural course of diabetes. There appears to be an association among oral infections, impaired sugar metabolism, and atherosclerosis, indicating a theoretical link between metabolic syndrome and periodontal disease. CLINICAL IMPLICATIONS: Control of periodontal disease may enhance glycemic control in patients with type 2 diabetes. In turn, improved glycemic control may contribute to a better control of periodontal disease.