Metagenomic Assessment of Different Interventions for Treatment of Chronic Periodontitis: A Systematic Review and Meta-Analysis

Abstract

Background: Chronic periodontitis is attributed to oral microbial imbalance and host inflammatory reaction. Objective: Our review addresses the question of: Are the available interventions able to regain oral microbial balance in patients having chronic periodontitis? Data Sources: We performed a comprehensive systematic search of MEDLine via Pubmed, Cochrane CENTRAL, Clinicalkey, Clarivate Analytics, Springer materials, Wiley, SAGE, Elsevier, Taylor & Francis group, and Wolter Kluwer, together with hand searching and searching the grey literature. Eligibility Criteria: We included interventional studies testing the microbiome analysis using metagenomic techniques as an outcome to any intervention for chronic periodontitis. Study Appraisal and Synthesis Methods: All studies were imported in Mendeley. The risk of bias was assessed using the specific tool for each study design. The results were analysed using RevMan. All the review steps were performed in duplicates. Results: The search yielded 2700 records. After exclusion steps, 10 records were found eligible. We included 5 RCTs, 1 non-RCT, 3 before-and-after studies, and 1 ongoing study. The studies tested non-surgical periodontal treatment with and without antibiotic coverage, probiotics, sodium hypochlorite rinse, and different toothpaste ingredients. One RCT tested the use of enamel matrix derivatives in cases with furcation involvement. Limitations: The eligible available studies were small in number. Also, the risk of bias and lack of a standardized protocol impaired the ability to pool all the results. Conclusions: The body of the available evidence is not sufficient, and future studies are recommended to better evaluate the effect of periodontal treatments on the periodontal microbiome.