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Review
. 2023 Dec:59:167-178.
doi: 10.1016/j.jdsr.2023.06.001. Epub 2023 Jun 18.

Systemic antibiotics adjuvants to scaling and root planing in type 2 diabetic and periodontitis individuals: Systematic review with network meta-analysis

Shih-Yun Wu  1   2 , Ching-Yi Wu  1   2 , Liang-Yu Lin  3   4 , Yu-Hsuan Chen  1 , Hsin-Yi Huang  5   6 , Yu-Lin Lai  1   2 , Shyh-Yuan Lee  1   2
Affiliations
Review

Systemic antibiotics adjuvants to scaling and root planing in type 2 diabetic and periodontitis individuals: Systematic review with network meta-analysis

Shih-Yun Wu et al. Jpn Dent Sci Rev. 2023 Dec.

Abstract

Targeting inflammatory pathways is considered a common strategy to control type 2 diabetes (T2D) and periodontitis. This overview was to validate systemic antibiotics as an adjuvant to scaling and root planing (SRP) for the treatments of periodontal patients with T2D. Literature searches were conducted using Web of Science, PubMed, Cochrane, and EMBASE. Randomized trials comparing SRP and systemic antibiotics on glycated hemoglobin (HbA1c) and probing pocket depth (PPD) in adults with T2D and periodontitis were analyzed using network meta-analysis and meta-regression. At 3-month postintervention, meta-analyses of 16 studies revealed that SRP and SRP plus systemic antibiotics (SRPa) had similar significant effects in reducing HbA1c levels of - 0.72% and - 0.96% respectively. While SRP and SRPa also, respectively, reduced PPD of - 0.67 and - 0.89 mm, SRPa showed a better reduction than SRP. At 6-month postintervention, meta-analyses of 7 trials revealed that only SRP was effective in reducing HbA1c levels (-0.29%) but not SRPa. Although both SRP and SRPa still significantly reduced PPD by - 0.56 and - 0.81 mm, respectively, there was no difference between them. The current overview suggested that routine SRP alone is highly recommended for patients with T2D and periodontitis, since systemic antibiotics as an adjuvant provide a rather short-term effect.

Keywords: Meta-analysis; Periodontitis; Scaling and root planing (SRP); Systemic antibiotics; Systemic inflammation; Type 2 diabetes.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Forest plots of the pairwise meta-analysis of reductions in (A) HbA1c and PPD at 3-month postintervention, (B) HbA1c and PPD at 6-month postintervention compared to the control.
Fig. 2
Fig. 2
Forest plots of the network meta-analysis of reductions in (A) HbA1c and PPD at 3 months postintervention, (B) HbA1c and PPD at 6 months postintervention compared to the control.
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