Systemic and local delivery of antibiotics in managing periodontal diseases: an update

The aim of this update was to evaluate the use of local and systemic antibiotics for the treatment of periodontal diseases. Due to the accumulation of bacteria in the form of dental plaque, the tissues and bone surrounding the teeth can become infected leading to periodontal diseases such as gingivitis and periodontitis. The main purpose of periodontal therapy is to eliminate or control the undesired effects of these bacteria present in the oral cavity in the form of biofilms. The use of antibiotics in conjunction with mechanical instrumentation has been suggested for the successful treatment of periodontal diseases. PubMed and google scholar databases were used to search through the past 30 years of literature using selected search criteria “Periodontal diseases*[TW] AND (gingivitis*[TW] OR periodontitis*[TW] OR antibiotics*[TW])” to identify articles/book chapters discussing polymerization shrinkage and possible solutions. In total, 46 articles/book chapters met the criteria for inclusion in the literature review. It can be concluded that the use of antibiotics is justified in cases with rapid signs and symptoms of destruction of periodontal tissues. Hence, antibiotics are suggested in cases of aggressive periodontitis, periodontal abscess, necrotizing ulcerative gingivitis, necrotizing ulcerative periodontitis and periodontitis that do not respond well to mechanical instrumentation alone. However, antibiotics may cause side effects and the bacteria may develop resistance, therefore dentists should keep in mind the adverse effects and benefits while prescribing antibiotics. Moreover, antibiotics should always be given as an adjunct to mechanical instrumentation and oral hygiene instructions to achieve successful outcome.