Abstract
The adjunctive use of fluoroquinolone (FQ) agents in patients with periodontitis produces contradictory results. There has been no meta-analysis performed based on the evaluations of FQ use that would enable making appropriate clinical decisions. Our study aimed to evaluate, via a systematic review and metaanalysis conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines, the clinical benefits, antimicrobial effects and safety profiles of the FQ agents administered to periodontitis patients under a conventional treatment regime. Relevant databases were searched for studies published up to May 2020, with the quality and risk of bias evaluations performed on the selected studies, and meta-analyses, funnel plots and heterogeneity tests carried out based on the obtained data. Any finding of p-value less than 0.05 was considered statistically significant. Quality and the risk of bias ranged from high to low. With acceptable heterogeneity and no reporting bias, the meta-analyses showed that local or systemic FQ use produced the following results: a reduced probing depth change (ΔPD) (p < 0.00001 at ≤3 months); reduced bleeding on probing (BOP) (p < 0.00001 at 3-6 months); reduced subgingival detection of Aggregatibacter actinomycetemcomitans for up to 12 months (p-values from <0.00001 to 0.001); and an insignificant number of adverse events (p ≥ 0.05) in patients subjected to a conventional therapy as compared to those subjected to an antibiotic-free therapy. Our study found evidence to show that FQ administration provides clinical benefits and ensures antibacterial effects in periodontitis patients subjected to a conventional therapy regime.
Highlights
It is well known that dental plaque can initiate gin gival inflammation, which, in many cases, can progress, leading to the destruction of the under lying connective tissue and the alveolar bone, resulting in the loss of the affected tooth.[1]
Our study aimed to evaluate, via a systematic review and metaanalysis conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines, the clinical benefits, antimicrobial effects and safety profiles of the FQ agents administered to periodontitis patients under a conventional treatment regime
With acceptable heterogeneity and no reporting bias, the meta-analyses showed that local or systemic FQ use produced the following results: a reduced probing depth change (ΔPD) (p < 0.00001 at ≤3 months); reduced bleeding on probing (%BOP) (p < 0.00001 at 3–6 months); reduced subgingival detection of Aggregatibacter actinomycetemcomitans for up to 12 months (p-values from
Summary
It is well known that dental plaque can initiate gin gival inflammation (gingivitis), which, in many cases, can progress, leading to the destruction of the under lying connective tissue and the alveolar bone (peri odontitis), resulting in the loss of the affected tooth.[1]. Variability in the individual host’s response to local factors plays a crucial role in this condition, and the loss of balance between the host’s response and the oral microbiome leads to development and progres sion of the disease.[1]. Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans) and members of the red complex (e.g., Porphyromonas gingivalis – P. gingivalis, Tannerella forsythia – T. forsythia and Treponema denticola – T. denticola) are the most sig nificant species associated with periodontitis.[3]. Periodontitis has been associated with the pre sence of various systemic disorders, such as coronary heart disease, diabetes, cerebrovascular disease, and pancreatic cancer.[5,6]
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