Systemic Antibiotics in Periodontal Treatment of Diabetic Patients: A Systematic Review

PLoS One. 2015 Dec 22;10(12):e0145262. doi: 10.1371/journal.pone.0145262. eCollection 2015.

Abstract

Aim: To evaluate the effects of systemic antibiotics in combination with scaling and root planing (SRP) on periodontal parameters, tooth loss and oral health-related quality of life in diabetes patients.

Materials and methods: Two independent reviewers screened for controlled clinical trials with at least 6-month follow-up in six electronic databases, registers of clinical trials, meeting abstracts and four major dental journals. After duplicates removal, electronic and hand searches yielded 1,878 records; 18 full-text articles were independently read by two reviewers. To evaluate the additional effect of antibiotic usage, pooled weighted mean differences and 95% confidence intervals were calculated using a fixed effects model.

Results: Five studies met the inclusion criteria, four of which were included in meta-analyses. The meta-analyses showed a significant effect favouring SRP plus antibiotic for reductions in mean probing depth (PD) (-0.22 mm [-0.34, -0.11]) and mean percentage of bleeding on probing (BoP) (4% [-7, -1]). There was no significant effect for clinical attachment level gain and plaque index reduction. No study reported on tooth loss and oral health-related quality of life.

Conclusion: Adjunctive systemic antibiotic use in diabetic patients provides a small additional benefit in terms of reductions in mean PD and mean percentage of BoP.

Prospero: CRD42013006389.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Clinical Trials as Topic
  • Databases, Factual
  • Diabetes Complications / drug therapy*
  • Diabetes Mellitus, Type 1 / drug therapy*
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Female
  • Humans
  • Male
  • Periodontitis / drug therapy*
  • Periodontitis / etiology

Substances

  • Anti-Bacterial Agents

Grants and funding

This study was funded by Research Support Foundation of the State of Rio de Janeiro (FAPERJ E-26/111.315/2014).