title: Systemic antibiotics in the treatment of aggressive periodontitis. A systematic review and a Bayesian Network meta-analysis.
abstract: OBJECTIVE
  The aim of this study was to assess the effect of systemic antibiotic therapy on the treatment of aggressive periodontitis (AgP).
  
  
  METHODS
  This study was conducted and reported in accordance with the PRISMA statement. The MEDLINE, EMBASE and CENTRAL databases were searched up to June 2014 for randomized clinical trials comparing the treatment of subjects with AgP with either scaling and root planing (SRP) alone or associated with systemic antibiotics. Bayesian network meta-analysis was prepared using the Bayesian random-effects hierarchical models and the outcomes reported at 6-month post-treatment.
  
  
  RESULTS
  Out of 350 papers identified, 14 studies were eligible. Greater gain in clinical attachment (CA) (mean difference [MD]: 1.08 mm; p < 0.0001) and reduction in probing depth (PD) (MD: 1.05 mm; p < 0.00001) were observed for SRP + metronidazole (Mtz), and for SRP + Mtz + amoxicillin (Amx) (MD: 0.45 mm, MD: 0.53 mm, respectively; p < 0.00001) than SRP alone/placebo. Bayesian network meta-analysis showed additional benefits in CA gain and PD reduction when SRP was associated with systemic antibiotics.
  
  
  CONCLUSIONS
  SRP plus systemic antibiotics led to an additional clinical effect compared with SRP alone in the treatment of AgP. Of the antibiotic protocols available for inclusion into the Bayesian network meta-analysis, Mtz and Mtz/Amx provided to the most beneficial outcomes.
authors.affiliation: Division of Periodontics, Federal University of Juiz de Fora (UFJF), Governador Valadares, MG, Brazil.
authors.forename: Cleverton Correa
authors.initials: CC
authors.lastname: Rabelo
authors.affiliation: Dental Research Division, Department of Periodontology, Guarulhos University, Guarulhos, SP, Brazil.
authors.forename: Magda
authors.initials: M
authors.lastname: Feres
authors.affiliation: Dental Research Division, Department of Periodontology, Guarulhos University, Guarulhos, SP, Brazil.
authors.forename: Cristiane
authors.initials: C
authors.lastname: Gonçalves
authors.affiliation: Dental Research Division, Department of Periodontology, Guarulhos University, Guarulhos, SP, Brazil.
authors.forename: Luciene C
authors.initials: LC
authors.lastname: Figueiredo
authors.affiliation: Dental Research Division, Department of Periodontology, Guarulhos University, Guarulhos, SP, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Faveri
authors.affiliation: Institute of Epidemiology & Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
authors.forename: Yu-Kang
authors.identifier: http://orcid.org/0000-0002-2461-474X
authors.initials: YK
authors.lastname: Tu
authors.affiliation: Department of Periodontics, College of Dentistry, The University of Iowa, Iowa City, IA, USA.|Unit of Basic Oral Investigation (UIBO), School of Dentistry, El Bosque University, Bogota, Colombia.
authors.forename: Leandro
authors.identifier: http://orcid.org/0000-0002-2838-1015
authors.initials: L
authors.lastname: Chambrone
mesh_terms: D010520:Aggressive Periodontitis / Q000188:drug therapy* / Q000628:therapy; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001499:Bayes Theorem; D003131:Combined Modality Therapy; D012534:Dental Scaling / Q000379:methods; D006801:Humans; D008795:Metronidazole / Q000627:therapeutic use; D017622:Periodontal Attachment Loss / Q000188:drug therapy; D010514:Periodontal Pocket / Q000188:drug therapy; D016745:Root Planing / Q000379:methods
chemical_list: D000900:Anti-Bacterial Agents; D008795:Metronidazole; D000658:Amoxicillin
keywords: aggressive periodontitis; amoxicillin; anti-infective agents; metronidazole; root planing; systematic review