Systemic Antibiotics in Periodontal Therapy: A Double-Edged Sword

BACKGROUNDThe use of systemic antibiotics to treat periodontitis has been a much debated topic for years, which has led to a number of controversial conclusions.In most cases of patients diagnosed with periodontitis -nonsurgical periodontal therapy, meticulous personal oral hygiene and regular maintenance visits to a periodontist are a successful treatment approach.Globally, the issue of antibiotic resistance is increasingly being addressed, which raises the question -are systemic antibiotics really necessary for the treatment of periodontitis?The purpose of this review is to give doctors an overview of recent research on the application of systemic antibiotics in periodontal care.REVIEW RESULTS While most chronic periodontitis cases are managed without the use of systemic antibiotics as a supplement, recent metaanalyses have demonstrated the potential therapeutic benefits of some systemic antibiotics when combined with SRP.A wide range of antibiotics used in conjunction with nonsurgical and surgical periodontal therapy has been reported in the literature.The most commonly used antibiotics are penicillins, tetracyclines, metronidazole, macrolides, clindamycin and ciprofloxacin.Today, it is unacceptable to prescribe systemic antibiotics as stand-alone therapy in patients with periodontitis.They would be beneficial in some single cases, with exacto non-surgical periodontal therapy necessarily performed beforehand, i.e. as an adjuvant.CONCLUSION The presented study shows that systemic antibiotics are currently finding their application in periodontal therapy.The notorious topic regarding antibiotic resistance is not to be underestimated, therefore antibiotic agents need to be judiciously prescribed only when necessary!