32 |
SANZ et al .
Available evidence In the systematic reviews of the present European Workshop, the role of antiseptics in active periodontal therapy has not been directly addressed. However, some evidence is available based on studies on the role of chlorhexidine use after subgingival instrumentation (da Costa et al., 2017). In addition, other factors should be considered: • It is unclear whether this should be a general recommendation for initial therapy. • It may be necessary to optimize mechanical plaque control before considering adjunctive chlorhexidine as an adjunct to subgingival instrumentation. • Specific considerations can be made when used in conjunction with full-mouth disinfection approaches and/or with systemic antimicrobials. • The medical status of the patient. • Adverse effects (staining) and economical costs should be considered. 6.5 | Intervention: Use of adjunctive locally administered antiseptics to subgingival instrumentation R2.14 | Do adjunctive locally administered antiseptics improve the clinical outcome of subgingival instrumentation? Evidence-based recommendation (2.14) Locally administered sustained-release chlorhexidine as an adjunct to subgingival instrumentation in patients with periodontitis may be considered . Supporting literature Herrera et al. (2020) Quality of evidence Nine RCTs, 6–9 months. 718/719 patients. High risk of bias and heterogeneity among studies. Grade of recommendation Grade 0—↔ Strength of consensus Consensus (10.5% of the group abstained due to potential CoI)
applications as an adjunct to subgingival debridement on short-term follow-up (6–9 months) (weighted mean difference (WMD) = 0.23, 95% CI [0.12; 0.34], p < .001 and significant heterogeneity). There are no long-term data available. No significant differences were found regarding CAL. Data on BOP were insufficient and no data on pocket closure or on number needed to treat (NNT) were provided.
Risk of bias High risk of bias and heterogeneity among studies.
Clinical relevance and effect size Effect size estimated for all PPD categories indicates an increased effect of about 10% in PPD reduction. Balance of benefit and harm No increase in adverse effects or differences in patient-reported outcome measures (PROMs) were observed. Economic considerations The cost for the product and the limited availability of products in European countries need to be considered. 6.6 | Intervention: Use of adjunctive locally administered antibiotics to subgingival instrumentation R2.15 | Do adjunctive locally administered antibiotics improve the clinical outcome of subgingival instrumentation? Evidence-based recommendation (2.15) Specific locally administered sustained-release antibiotics as an adjunct to subgingival instrumentation in patients with periodontitis may be considered . Supporting literature Herrera et al. (2020) Quality of evidence PPD reduction (6–9 months): Atridox n = 2, 19/19 patients; Ligosan: n = 3, 232/236 patients; Arestin: n = 6, 564/567 patients. High risk of bias and heterogeneity in the majority of studies. Grade of recommendation Grade 0—↔ Strength of consensus Consensus (7.8% of the group abstained due to potential CoI)
Background
Intervention There is insufficient evidence on the benefits of locally administered sustained-release antiseptics as an adjunct to subgingival debride - ment in patients with periodontitis. Available evidence The systematic review (Herrera et al., 2020) revealed results from studies on products containing chlorhexidine (Periochip n = 9, Chlosite n = 2). One product (Periochip) demonstrated statistically significantly greater PPD reduction following single or multiple
Background
Available evidence Of the products available on the European market, the systematic review (Herrera et al., 2020) revealed statistically significantly im - proved PPD reduction of locally applied antibiotics as an adjunct to subgingival debridement on short-term follow-up (6–9 months) for Atridox (two studies, WMD = 0.80; 95% CI [0.08; 1.52]; p = .028), Ligosan (three studies, WMD = 0.52; 95% CI [0.28; 0.77]; p < .001)
Made with FlippingBook Annual report