Role of antibiotics in aggressive periodontitis: A review
Journal name: Journal of Indian Society of Periodontology
Original article title: Role of antibiotics in generalized aggressive periodontitis: A review of clinical trials in humans
The Journal of Indian Society of Periodontology (JISP) publishes original scientific articles on periodontology (the study of supporting structures of teeth) and oral implantology. It is a bimonthly open-access journal with special issues for specific occasions.
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Original source:
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Annapurna Ahuja, C. S. Baiju, Vipin Ahuja
Journal of Indian Society of Periodontology:
(A bimonthly open-access journal)
Full text available for: Role of antibiotics in generalized aggressive periodontitis: A review of clinical trials in humans
Year: 2012 | Doi: 10.4103/0972-124X.100903
Copyright (license): CC BY-NC-SA
Summary of article contents:
Introduction
Periodontal diseases arise from various factors, with microorganisms playing a pivotal role in their pathogenesis. Traditional treatment methods, such as scaling and root planing (SRP), often prove insufficient, especially in aggressive periodontal diseases characterized by specific microbial colonies resistant to mechanical removal. Consequently, the incorporation of systemic antimicrobials has emerged as a crucial adjunct to conventional therapy to effectively address these persistent infections. This systematic review aims to evaluate the effectiveness of systemic antibiotics, specifically amoxicillin and metronidazole, in conjunction with SRP in patients suffering from generalized aggressive periodontitis, assessing both clinical and microbiological parameters.
The Role of Antibiotics in Treating Aggressive Periodontitis
The rationale for using systemic antibiotics alongside mechanical therapy stems from the complex structure of microbial biofilms in periodontal diseases. Mechanical cleaning processes may leave behind resilient bacteria that can quickly recolonize subgingival areas, leading to disease recurrence. In this review, three randomized controlled trials were assessed, all of which indicated clinical benefits when antibiotics were used alongside SRP compared to SRP alone. However, the studies exhibited considerable heterogeneity in design, dosage, and patient demographics, which limited the ability to perform a comprehensive statistical analysis. Despite these limitations, the findings suggest that adjunctive antibiotic therapy may play a significant role in improving treatment outcomes for patients with generalized aggressive periodontitis, potentially leading to better control over recalcitrant infections.
Conclusion
In conclusion, while the current review found some evidence supporting the combination of systemic antibiotics with scaling and root planing in the management of generalized aggressive periodontitis, the lack of sufficient high-quality, homogenous studies hampers definitive conclusions. The varying methodologies and small sample sizes across the studies created challenges in drawing generalized recommendations regarding dosages and treatment duration for antibiotic therapy. Future research should focus on standardized protocols with larger cohorts to better understand the adjunctive role of antibiotics and determine effective treatment strategies for periodontal diseases that are resistant to traditional mechanical interventions.
FAQ section (important questions/answers):
What role do antibiotics have in treating aggressive periodontitis?
Antibiotics are used adjunctively with scaling and root planning (SRP) to manage aggressive periodontitis. They help eliminate bacteria that mechanical treatments alone may not effectively target, addressing the biofilm and enhancing the treatment outcome.
How effective is the combination of SRP and systemic antibiotics?
The combination of SRP and systemic antibiotics has shown beneficial improvements in clinical and microbiological parameters in patients with generalized aggressive periodontitis. However, the studies are limited and varied, making definitive conclusions difficult.
What was the focus of the systematic review conducted?
The systematic review aimed to evaluate the efficacy of systemic antibiotics, specifically amoxicillin and metronidazole, in conjunction with SRP for treating generalized aggressive periodontitis by analyzing clinical and microbiological outcomes.
What criteria were used to include studies in the review?
Included studies had to be randomized, double-blinded, and placebo-controlled clinical trials lasting six months, assessing the effects of systemic antibiotics in conjunction with SRP in human subjects with generalized aggressive periodontitis.
Why was statistical analysis not performed on the included studies?
Statistical analysis could not be performed due to the heterogeneity among the studies in terms of design, antibiotic dosage, duration of treatment, and outcome measures. This variability limited the ability to draw uniform conclusions.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Role of antibiotics in aggressive periodontitis: A review”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Antibiotic (Antibacterial):
Antibiotics are crucial in managing infections caused by specific microorganisms associated with periodontal diseases, particularly aggressive periodontitis. Systemic administration may serve as an adjunct therapy, enhancing the effectiveness of mechanical treatments such as scaling and root planing by targeting bacteria that are difficult to eliminate through mechanical means alone.
2) Quality:
Quality in clinical studies refers to the integrity and trustworthiness of the research methodology including randomization, blinding, and appropriate sample sizes. Higher quality studies yield more reliable results and conclusions, making quality assessment essential for determining the efficacy of treatments such as antibiotic use in periodontal disease management.
3) Study (Studying):
Study refers to a systematic investigation undertaken to learn about the effectiveness of scaling and root planing combined with antibiotics versus SRP alone in treating generalized aggressive periodontitis. The number of qualifying studies, their design variations, and outcomes impact the reliability and applicability of the findings in clinical practice.
4) Disease:
Disease in this context specifically pertains to periodontal diseases like generalized aggressive periodontitis, which involve microbial infections leading to inflammation and damage in periodontal tissues. Understanding the nature of the disease assists in developing effective treatment protocols, including the potential role of systemic and local antibiotics.
5) Table:
Tables in research papers summarize critical aspects of the studies, including demographics, treatment modalities, findings, and quality assessments. They provide clear, concise visual information that aids readers in quickly understanding and comparing research data, such as the outcomes of various treatment approaches for aggressive periodontitis.
6) Drug:
A drug, particularly antibiotics like amoxicillin and metronidazole, is vital in systemic treatment strategies for managing bacterial infections in periodontal diseases. The choice of drugs, their dosages, and treatment duration play significant roles in achieving desired clinical outcomes in patients with aggressive periodontitis.
7) Science (Scientific):
Scientific methodology encompasses systematic research characterized by rigor, clarity, and replicability. In periodontal research, scientific principles enable the examination of treatment efficacy, such as the use of antibiotics in conjunction with mechanical therapy. This methodological framework is fundamental for establishing evidence-based practices in dentistry.
8) Pur (Pūr):
In the context of quality assessment, 'poor' describes studies that fail to meet adequate methodological standards, limiting their reliability and applicability. Poor quality studies could provide inconclusive or misleading results, emphasizing the importance of rigorous research design and evaluation in clinical investigations for periodontal diseases.
9) Pir (Pīr):
Peer review enhances the credibility of published research by subjecting studies to evaluation by experts in the field before publication. The peer review process ensures that only high-quality research findings contribute to the body of knowledge, influencing clinical practices in managing diseases like aggressive periodontitis.
10) Language:
Language plays a crucial role in disseminating research findings. The use of English in the included studies ensures accessibility and comprehension for a global audience of researchers, clinicians, and practitioners. Clear language facilitates understanding of complex concepts and findings relevant to aggressive periodontitis treatment.
11) Bleeding:
Bleeding on probing is a significant clinical parameter used to assess periodontal health. It serves as an indicator of inflammation and disease severity in periodontal conditions. Monitoring changes in bleeding following treatment interventions provides insight into the effectiveness of therapies like scaling and root planing combined with antibiotics.
12) Pregnant:
Pregnant individuals are often excluded from clinical trials due to ethical concerns and potential risks associated with treatment interventions. This exclusion is crucial in periodontal studies to ensure the safety of both the mother and fetus, impacting the generalizability of research findings to diverse patient populations.
13) Reason:
Reasoning in research involves justification for study design choices, inclusion/exclusion criteria, and outcome measures. Understanding the rationale behind these decisions is essential for evaluating treatment efficacy and clinical implications, especially when assessing the role of antibiotics and mechanical therapies in aggressive periodontitis.
14) Animal:
Animal studies provide foundational insights and preliminary data before conducting human clinical trials. They help researchers explore disease mechanisms and treatment effects, informing the development of therapeutic strategies. However, findings from animal studies must be cautiously translated to human conditions due to interspecies differences.
15) Hand:
In the context of periodontal treatment, 'hand' refers to the manual scaling instruments used in conjunction with mechanical therapies. Hand instruments are vital for effective plaque removal in periodontal pockets, and understanding their use alongside systemic antibiotics can enhance treatment outcomes in aggressive periodontitis management.
Other Health Sciences Concepts:
Discover the significance of concepts within the article: ‘Role of antibiotics in aggressive periodontitis: A review’. Further sources in the context of Health Sciences might help you critically compare this page with similair documents:
Randomized controlled trial, Periodontal disease, Systematic Review, Scaling and root planning, Disease recurrence, Microbial biofilm, Bleeding On Probing, Mechanical therapy, Systemic antibiotic, Anti-infective therapy, Included studies, Excluded studies.