Antibiotic therapy as an adjunct to scaling and root planing in smokers: a systematic review and meta-analysis

Abstract

The aim of this study was to perform a systematic reviewand meta-analysis to examine the effect of systemic antibiotics in theperiodontal treatment of smokers. The selection criteria were as follows:controlled randomized clinical trials; studies published in English; studieswith smoker patients diagnosed with chronic periodontitis; patientswithout systemic diseases; studies that used systemic antibiotic therapyassociated with periodontal treatment; studies that presented resultsfor the test and control groups and assessments of clinical periodontalparameters, such as probing depth (PD), bleeding on probing (BOP), andclinical attachment level (CAL). The differences in average weights werecalculated with a confidence interval (CI) of 95% for PD reduction, CALgain and BOP. The means of the periodontal clinical parameters werecompared between the baseline and post-treatment periods between thetest groups and the control groups. The heterogeneity was assessed usingthe Cochran Q test (Q (df = 3), α = 5%). A total of 67 articles were found,and after the selection process, three randomized controlled trials wereincluded in the meta-analysis. The results indicate that SRP associatedwith systemic antibiotics promoted additional benefits when comparedto SRP alone, with a greater reduction of PD (p = 0.0359, CI = -0.42, -0.01)and a g ain o f C AL ( p = 0.0161, C I = - 0.39, - 0.04). T here w as a m odestPD reduction (PD, DM -0.21) and a modest CAL gain (CAL, DM -0.22).The results of our meta-analysis reveal the clinical benefits of systemicantibiotics as an adjunct to the non-surgical periodontal treatment ofsmokers. These clinical improvements, although statistically significant,appeared to be of little clinical relevance