Metronidazole and amoxicillin association in aggressive periodontitis: A systematic review and meta-analysis

The aim of this systematic review and meta-analysis was to evaluate the effects of metronidazole and amoxicillin in combination with mechanical therapy for the treatment of aggressive periodontitis. This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered in the International Prospective Record of Systematic Reviews (CRD42018111595). The research was performed using PubMed/MEDLINE, Web of Science, Scopus, and Cochrane Library databases till December 2019 and included randomized clinical trials that analyzed whether the use of systemic metronidazole and amoxicillin improved the treatment response in patients with aggressive periodontitis. Altogether, 137 articles were identified and 4 studies were selected after applying the inclusion and the exclusion criteria. No statistically significant difference was observed in the clinical attachment level between the use of systemic antibiotics combined with scaling and root planning (SRP) and SRP without antibiotics (p = 0.52, mean deviation [MD]: 0.21, 95% confidence interval [CI]: −0.04–0.46). There was a statistically significant difference in the probing depth between the use of systemic antibiotics with SRP and the use of SRP alone (p = 0.02, MD: 0.40, 95% CI: 0.02–0.78). Gain in the clinical attachment level was not significantly higher when systemic antibiotics were used with SRP compared to SRP without antibiotics in the treatment of aggressive periodontitis. However, a statistically significant difference was observed in reduction in the probing depth.