Abstract
BackgroundTo compare the effectiveness of systemic doxycycline as an adjunct to scaling and root planing (SRP) with SRP alone in improving periodontal clinical attachment level and glycemic control in diabetic patients with periodontitis.MethodsTwo independent reviewers (KY and SJ) screened two electronic databases, PubMed and Scopus, for randomized clinical trials on the use of systemic doxycycline as an adjunct to scaling and root planing in improving periodontal status and glycemic control in diabetic patients with periodontitis using predetermined selection criteria within a 3-month period. The reviewers independently did data screening, data selection, data extraction and risk of bias. Quality of studies involved was analysed using the revised Cochrane Risk of Bias 2.0. Weighted standard mean differences (SMD) and 95% confidence intervals were calculated using a random effects meta-analysis model. Publication bias was evaluated using funnel plot. Quality of evidence was evaluated by Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.ResultsElectronic searches provided 1358 records and six studies were selected. The meta-analyses indicated that there was no statistically significant difference in the improvement of periodontal status with the use of systemic doxycycline as an adjunct for scaling and root planing (SRP). SMD of clinical attachment levels (− 0.22 [− 0.52, 0.08]) and HbA1c levels (− 0.13 [− 0.41, 0.15]) were calculated. Overall risk of bias is high in 2 out of 6 studies involved.ConclusionSystemic doxycycline when used in addition to scaling and root planing yields no significant improvement of clinical attachment levels for periodontal status and reduction of HbA1c levels in treatment of diabetic patients with periodontitis when comparing the test group to the control group.
Highlights
To compare the effectiveness of systemic doxycycline as an adjunct to scaling and root planing (SRP) with SRP alone in improving periodontal clinical attachment level and glycemic control in diabetic patients with periodontitis
There is a need to identify the efficacy of the systemic doxycycline in improving the periodontal health and glycemic control in diabetic patients with periodontitis given the lack of concrete evidence to show improved metabolic control and periodontal status when systemic doxycycline is used as an adjunct to scaling and root planing
This review reported based on PRISMA guidelines and was registered in PROSPERO database (CDR42018103828). This is a systematic review of randomized clinical trials that evaluate differences in clinical attachment levels (CAL), pocket depth (PD), bleeding on probing (BOP) and glycated hemoglobin (HbA1c) levels in diabetic patients with periodontitis after scaling and root planing (SRP) with systemic doxycycline in comparison to just SRP alone
Summary
To compare the effectiveness of systemic doxycycline as an adjunct to scaling and root planing (SRP) with SRP alone in improving periodontal clinical attachment level and glycemic control in diabetic patients with periodontitis. A substantially larger increase in CAL in diabetic patients with periodontitis who were given systemic doxycycline were seen as compared to without doxycycline after 3 months [8, 9]. There is a need to identify the efficacy of the systemic doxycycline in improving the periodontal health and glycemic control in diabetic patients with periodontitis given the lack of concrete evidence to show improved metabolic control and periodontal status when systemic doxycycline is used as an adjunct to scaling and root planing. This review based on a systematic search will identify the eligible studies and analyse data to determine the efficacy of systemic doxycycline as an adjunct to scaling and root planing in diabetic patients with periodontitis
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