Enhancing Periodontitis Treatment: A Comprehensive Literature Review of Locally Delivered Antibiotics as Adjunctive Therapy

Abstract

Background: Periodontitis is a prevalent and persistent infection that can significantly affect overall health. While scaling and root planing are effective treatments, they may not fully remove bacterial biofilms in difficult-to-reach areas, such as furcations and deep pockets. Therefore, numerous studies have demonstrated that supplementing mechanical debridement with locally delivered antibiotics can improve clinical outcomes. Objective: This study aims to review the effectiveness of different types of locally delivered antibiotics as adjunctive therapy to scaling and root planing in treating periodontitis. Methods: Pubmed, Scopus and Google Scholar were utilized to obtain papers addressing locally delivered antibiotics in periodontitis patients, antibiotics in periodontitis, or antimicrobial agents in periodontitis up to February 1, 2023. Results: Treatment with locally delivered antibiotics led to notable improvements in clinical outcomes. These improvements encompassed reductions in probing depths, gingival inflammation, and bleeding on probing. Additionally, enhancements in clinical attachment level and periodontal pocket depth reduction were consistently observed in the included studies. Conclusion: Based on individual antimicrobial agent analyses, we are unable to determine which local antibiotic is the best. It is challenging to accurately assess the use of sustained or released local antimicrobials due to the unique features of each product. Local medication administration into the periodontal pocket could be an effective therapy adjunct to mechanical instruments.