Local antibiotic/antimicrobial therapy in the periodontal treatment. A review of the literature

OBJECTIVES. This review is intended to present a narrative report of the latest scientific papers published in the literature, concerning the use of local antibiotics and antimicrobial agents in addition to causal periodontal therapy in order to provide an update on the latest scientific evidence about the benefits, limitations and clinical results obtained by the use of such substances. MATERIALS AND METHODS. A narrative review of the literature has been conducted, using PubMed, Medline and Google Scholar including articles published in peer-reviewed journals between January 2009 and December 2014. The following keywords were used: "local delivery antimicrobials", "local delivery antibiotics", "local delivery AND periodontitis", "local antibiotics AND periodontitis", "local antimicrobials AND periodontitis" RESULTS. From this review we can infer that the use of local antibiotics or antimicrobial agents delivers significant benefits in periodontal therapy. Although it cannot replace the mechanical therapy, it is a useful aid, avoiding many of the side effects that systemic antibiotic therapy may involve. CONCLUSIONS. The local antibiotic and antimicrobial therapy is effective in the treatment of periodontal disease when used in addition to the mechanical therapy. In the opinion of the authors, the use of such agents should be preferred in cases of localized acute lesions or individual sites that do not respond to the causal therapy, always following a thorough scaling and root planing of the areas affected by the pathological process. However, to date, it is not possible to establish guidelines on the use of these agents given the heterogeneity of the protocols used in the various studies and the lack of consensus accepted by the scientific community.