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. 2023 Mar;27(3):955-970.
doi: 10.1007/s00784-023-04871-0. Epub 2023 Feb 2.

Local drug delivery in the treatment of furcation defects in periodontitis: a systematic review

Georgios S Chatzopoulos  1   2 , Vasiliki P Koidou  3 , Lazaros Tsalikis  4
Affiliations

Local drug delivery in the treatment of furcation defects in periodontitis: a systematic review

Georgios S Chatzopoulos et al. Clin Oral Investig. 2023 Mar.

Abstract

Objectives: To evaluate the effect of subgingival administration of various antimicrobials and host-modulating agents in furcation defects as an adjunct to scaling and root planing (SRP) compared to SRP alone or combined with placebo.

Methods: A systematic review was carried out using MEDLINE-PubMed, Embase, and Scopus for articles up to October 2022 in addition to hand searches. All longitudinal studies that evaluated the effect of subgingival application of antimicrobial and host-modulating agents in furcation defects as adjuncts to SRP compared to SRP alone or SRP + placebo with at least 3 months of follow-up were eligible for inclusion.

Results: A total of eight studies were included. Superior clinical treatment outcomes were shown when alendronate, rosuvastatin, boric acid, simvastatin, and tetracycline (only at 3 months) were utilized in furcation defects in conjunction with SRP alone or SRP + placebo. Significant improvement was reported in radiographic bone defect depth and defect depth reduction when SRP was supplemented with alendronate, rosuvastatin, boric acid, and simvastatin.

Conclusions: Within the limitations of this review, the adjunctive subgingival administration of medications and host-modulating agents in furcation defects may confer additional clinical and radiographic benefits than non-surgical periodontal treatment alone. Future investigations are needed to confirm their long-term effectiveness.

Clinical relevance: Local host modulators and antimicrobials may be used supplementary to enhance the clinical and radiographic treatment outcomes of conventional periodontal therapy in furcation defects.

Keywords: Adjunctive therapy; Local drug delivery systems; Non-surgical periodontal therapy; Periodontitis; Host-modulating agents; Systematic review.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram of the study selection process
Fig. 2
Fig. 2
Risk of bias assessment of the included studies
See this image and copyright information in PMC

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