An Evidence-Based Update on the Impact of Local Antimicrobials as Adjunct to Periodontal Therapy
Local antimicrobials as adjunct to mechanical periodontal therapy have been used widely to enhance the outcome of treatment. However, consensus has yet to be achieved regarding what and how these antimicrobials can be used. Therefore, this narrative review highlights the most common antimicrobi...
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Sulaimani Polytechnic University
2023-06-01
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| Series: | Kurdistan Journal of Applied Research |
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| Online Access: | https://www.kjar.spu.edu.iq/index.php/kjar/article/view/961 |
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| author | Nabaz Yahya Hussein Sadat Abdulla Aziz Twana Mohammed M. Ways Omed Amiri Hisham Al-Obaidi Dianne Ford |
| author_facet | Nabaz Yahya Hussein Sadat Abdulla Aziz Twana Mohammed M. Ways Omed Amiri Hisham Al-Obaidi Dianne Ford |
| author_sort | Nabaz Yahya Hussein |
| collection | DOAJ |
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Local antimicrobials as adjunct to mechanical periodontal therapy have been used widely to enhance the outcome of treatment. However, consensus has yet to be achieved regarding what and how these antimicrobials can be used. Therefore, this narrative review highlights the most common antimicrobials examined and provides an updated analysis of the benefits, limitations, and clinical outcomes associated with use of antimicrobials as adjunct to mechanical periodontal therapy. Based on the evidences gathered, it is clear that combining local antimicrobial agents with scaling and root debridement (SRD) offers significant therapeutic advantages in periodontal therapy and minimizing many side effects linked to systemic antibiotic therapy. Amongst the antimicrobials used, chlorhexidine (CHX) showed the most significant clinical improvement, followed by doxycycline (DOX), tetracycline, and metronidazole (MTZ), all of which helped reduce periodontal bacteria load and improve treatment outcome. CHX demonstrated the greatest clinical improvement due to its broad-spectrum antimicrobial activity, strong substantivity, and its application in sustained-release formulations. DOX followed closely in effectiveness, offering a unique advantage through its dual role as both an antimicrobial and a matrix metalloproteinase inhibitor. Tetracycline, though slightly less effective than DOX, still provided considerable clinical benefits, especially when used in sustained-release systems, despite increasing bacterial resistance in some cases. MTZ showed the lowest clinical improvement among the agents reviewed, but it remains valuable due to its targeted action against anaerobic bacteria, which are prominent in periodontal infections. The findings of this study will help the general practitioners select the most suitable local antimicrobial therapy as adjunct to mechanical periodontal therapy.
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| format | Article |
| id | doaj-art-cae67c67d2394233b5c5ff51b2945d7d |
| institution | Kabale University |
| issn | 2411-7684 2411-7706 |
| language | English |
| publishDate | 2023-06-01 |
| publisher | Sulaimani Polytechnic University |
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| series | Kurdistan Journal of Applied Research |
| spelling | doaj-art-cae67c67d2394233b5c5ff51b2945d7d2025-02-11T20:59:59ZengSulaimani Polytechnic UniversityKurdistan Journal of Applied Research2411-76842411-77062023-06-018110.24017/science.2023.1.6An Evidence-Based Update on the Impact of Local Antimicrobials as Adjunct to Periodontal TherapyNabaz Yahya Hussein0Sadat Abdulla Aziz1https://orcid.org/0000-0001-9455-2639Twana Mohammed M. Ways2https://orcid.org/0000-0002-7595-2159Omed Amiri3Hisham Al-Obaidi4https://orcid.org/0000-0001-9735-0303Dianne Ford5https://orcid.org/0000-0001-8121-9319Department of Periodontics, College of Dentistry, University of Sulaimani, Sulaymaniyah, Iraq | Halabja General Health Directory, Ministry of Health, Halabja Governate, IraqDepartment of Anesthesia, College of Health Sciences, Cihan University-Sulaimaniya, Sulaimaniyah, Iraq. | Department of Basic Sciences, College of Veterinary Medicine, University of Sulaimani, Sulaymaniyah, Iraq. Department of Pharmaceutics, College of Pharmacy, University of Sulaimani, Sulaymaniyah, Iraq.Cihan University Sulaimaniya Research Center (CUSRC), Cihan University Sulaimaniya, Sulaymaniyah, IraqSchool of Pharmacy, University of Reading, Reading, RG6 6AD, UKFaculty of Health & Life Sciences, Northumbria University, Newcastle upon Tyne, UK Local antimicrobials as adjunct to mechanical periodontal therapy have been used widely to enhance the outcome of treatment. However, consensus has yet to be achieved regarding what and how these antimicrobials can be used. Therefore, this narrative review highlights the most common antimicrobials examined and provides an updated analysis of the benefits, limitations, and clinical outcomes associated with use of antimicrobials as adjunct to mechanical periodontal therapy. Based on the evidences gathered, it is clear that combining local antimicrobial agents with scaling and root debridement (SRD) offers significant therapeutic advantages in periodontal therapy and minimizing many side effects linked to systemic antibiotic therapy. Amongst the antimicrobials used, chlorhexidine (CHX) showed the most significant clinical improvement, followed by doxycycline (DOX), tetracycline, and metronidazole (MTZ), all of which helped reduce periodontal bacteria load and improve treatment outcome. CHX demonstrated the greatest clinical improvement due to its broad-spectrum antimicrobial activity, strong substantivity, and its application in sustained-release formulations. DOX followed closely in effectiveness, offering a unique advantage through its dual role as both an antimicrobial and a matrix metalloproteinase inhibitor. Tetracycline, though slightly less effective than DOX, still provided considerable clinical benefits, especially when used in sustained-release systems, despite increasing bacterial resistance in some cases. MTZ showed the lowest clinical improvement among the agents reviewed, but it remains valuable due to its targeted action against anaerobic bacteria, which are prominent in periodontal infections. The findings of this study will help the general practitioners select the most suitable local antimicrobial therapy as adjunct to mechanical periodontal therapy. https://www.kjar.spu.edu.iq/index.php/kjar/article/view/961Periodontal therapyAdjunc-tiveLocal antimicrobialsEffec-tiveness Treatment outcome |
| spellingShingle | Nabaz Yahya Hussein Sadat Abdulla Aziz Twana Mohammed M. Ways Omed Amiri Hisham Al-Obaidi Dianne Ford An Evidence-Based Update on the Impact of Local Antimicrobials as Adjunct to Periodontal Therapy Kurdistan Journal of Applied Research Periodontal therapy Adjunc-tive Local antimicrobials Effec-tiveness Treatment outcome |
| title | An Evidence-Based Update on the Impact of Local Antimicrobials as Adjunct to Periodontal Therapy |
| title_full | An Evidence-Based Update on the Impact of Local Antimicrobials as Adjunct to Periodontal Therapy |
| title_fullStr | An Evidence-Based Update on the Impact of Local Antimicrobials as Adjunct to Periodontal Therapy |
| title_full_unstemmed | An Evidence-Based Update on the Impact of Local Antimicrobials as Adjunct to Periodontal Therapy |
| title_short | An Evidence-Based Update on the Impact of Local Antimicrobials as Adjunct to Periodontal Therapy |
| title_sort | evidence based update on the impact of local antimicrobials as adjunct to periodontal therapy |
| topic | Periodontal therapy Adjunc-tive Local antimicrobials Effec-tiveness Treatment outcome |
| url | https://www.kjar.spu.edu.iq/index.php/kjar/article/view/961 |
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