title: Systemic Antibiotics in Periodontal Treatment of Diabetic Patients: A Systematic Review.
abstract: OBJECTIVE
  To evaluate the effects of systemic antibiotics in combination with scaling and root planing (SRP) on periodontal parameters, tooth loss and oral health-related quality of life in diabetes patients.
  
  
  METHODS
  Two independent reviewers screened for controlled clinical trials with at least 6-month follow-up in six electronic databases, registers of clinical trials, meeting abstracts and four major dental journals. After duplicates removal, electronic and hand searches yielded 1,878 records; 18 full-text articles were independently read by two reviewers. To evaluate the additional effect of antibiotic usage, pooled weighted mean differences and 95% confidence intervals were calculated using a fixed effects model.
  
  
  RESULTS
  Five studies met the inclusion criteria, four of which were included in meta-analyses. The meta-analyses showed a significant effect favouring SRP plus antibiotic for reductions in mean probing depth (PD) (-0.22 mm [-0.34, -0.11]) and mean percentage of bleeding on probing (BoP) (4% [-7, -1]). There was no significant effect for clinical attachment level gain and plaque index reduction. No study reported on tooth loss and oral health-related quality of life.
  
  
  CONCLUSIONS
  Adjunctive systemic antibiotic use in diabetic patients provides a small additional benefit in terms of reductions in mean PD and mean percentage of BoP.
  
  
  BACKGROUND
  
  CRD42013006389.
authors.affiliation: Department of Periodontology, School of Dentistry, Rio de Janeiro State University, Rio de Janeiro, Brazil.
authors.forename: Caroline Moura Martins Lobo
authors.initials: CM
authors.lastname: Santos
authors.affiliation: Department of Periodontology, School of Dentistry, Rio de Janeiro State University, Rio de Janeiro, Brazil.
authors.forename: Ronaldo
authors.initials: R
authors.lastname: Lira-Junior
authors.affiliation: Department of Periodontology, School of Dentistry, Rio de Janeiro State University, Rio de Janeiro, Brazil.
authors.forename: Ricardo Guimarães
authors.initials: RG
authors.lastname: Fischer
authors.affiliation: Department of Community and Preventive Dentistry, School of Dentistry, Rio de Janeiro State University, Rio de Janeiro, Brazil.
authors.forename: Ana Paula Pires
authors.initials: AP
authors.lastname: Santos
authors.affiliation: Department of Community and Preventive Dentistry, School of Dentistry, Rio de Janeiro State University, Rio de Janeiro, Brazil.
authors.forename: Branca Heloisa
authors.initials: BH
authors.lastname: Oliveira
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D016208:Databases, Factual; D048909:Diabetes Complications / Q000188:drug therapy*; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D010518:Periodontitis / Q000188:drug therapy* / Q000209:etiology
chemical_list: D000900:Anti-Bacterial Agents