Locally Delivered Macrolides As An Adjunct To Scaling And Root Planing In The Treatment Of Chronic Periodontitis:A Meta Analysis

PURPOSE: The present meta analysis was designed to determine the effects of macrolides group of antibiotics as local drug delivery agents to scaling and root planing(SRP),compared with SRP alone or plus placebo.METHODS: Electronic and manual literature searches were conducted to select randomized controlled trials(RCTs)comparing SRP + macrolides versus SRP alone using the following databases:PubMed,Cochrane? Library,Science Direct,EMbase,CNKI,Wan fang database and VIP data until August 2018.Two reviewers independently extracted the data and evaluated the methodological quality of the included studies.RevMan 5.3 was applied for meta analysis.RESULTS: Seven papers were obtained,which included 439 patients with chronic periodontitis.Meta analysis showed that in the two groups the changes in probing depth(PD)[MD=0.77;95% CI(0.48-1.05);P<0.00001],clinical attachment loss(CAL)[MD=0.74;95%CI(0.39-1.10);P<0.0001],plaque index(PI)[MD=0.30;95% CI(0.17-0.43);P<0.00001],modified sulcus bleeding index(mSBI)[MD=0.23;95% CI(0.15-0.32);P<0.00001]at 3 month and 6 month of PD[MD=1.15;95% CI(0.41-1.89);P=0.002]were significantly different;the difference of CAL[MD=0.92;95% CI(0.43-1.40);P=0.0002],PI[MD=0.51;95% CI(0.07-0.95);P=0.02] and mSBI [MD= 0.18;95% CI(0.07-0.29);P=0.002] was also significant(P<0.05).CONCLUSIONS:SRP combined with local macrolides adjuvant treatment for chronic periodontitis is effective in reduction of probing depth(PD)and remission of inflammation in short-term observation.