Comparación de efectividad de amoxicilina/metronidazol y de azitromicina como terapia coadyuvante durante el tratamiento periodontal no quirúrgico en pacientes con periodontitis crónica severa generalizada. Revisión sistemática
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2022
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Universidad Finis Terrae (Chile) Facultad de Odontología
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Objetivo general: Establecer si la amoxicilina más metronidazol es más efectiva que la azitromicina como terapia coadyuvante durante el tratamiento periodontal no quirúrgico (TPNQ) en pacientes diagnosticados con periodontitis crónica severa generalizada.
Metodología: Se realizó una revisión sistemática de la literatura según el protocolo PRISMA utilizando las bases de datos PubMed y Scielo. Se incluyeron ensayos clínicos que hayan utilizado amoxicilina con metronidazol, azitromicina o ambos como coadyuvante al TPNQ, publicados en los últimos 10 años. Se utilizaron las variables reducción de profundidad al sondaje (PS), reducción de sangrado al sondaje (SS) y reducción de nivel de inserción clínica (NIC).
Resultados: Un total de 184 artículos fueron revisados, de los cuales 7 ensayos clínicos cumplieron con los criterios y fueron incluidos en la revisión. Tres de éstos utilizaron amoxicilina con metronidazol, uno utilizó azitromicina y tres utilizaron ambos antibióticos en sus grupos de estudio.
Conclusiones: Ambos esquemas antibióticos utilizados en los ensayos clínicos (azitromicina y amoxicilina con metronidazol) como coadyuvantes al TPNQ en pacientes con periodontitis crónica severa generalizada, obtuvieron mejores resultados en los parámetros clínicos de PS, SS y NIC al ser comparados con TPNQ sin uso de antimicrobianos. La terapia antibiótica de amoxicilina con metronidazol, utilizada en la TPNQ, logra resultados significativamente mejores que azitromicina según los parámetros clínicos de PS, SS y NIC. Se sugiere que estudios futuros implementen otros esquemas antibióticos para determinar alternativas más efectivas como coadyuvantes en el TPNQ.
Objective: To establish whether amoxicillin plus metronidazole is more effective than azithromycin as adjunctive therapy during non-surgical periodontal treatment (NSPT) in patients diagnosed with generalized severe chronic periodontitis. Methodology: Systematic review of the literature according to the PRISMA protocol using the PubMed and Scielo databases. Clinical trials that have used amoxicillin with metronidazole, azithromycin or both as an adjuvant to NSPT, published in the last 10 years were included. The variables probing depth reduction (PD), bleeding on probing reduction (BOP) and clinical attachment level reduction (CAL) were used. Results: A total of 184 articles were reviewed, of which 7 met the eligibility criteria and were included in the review. Three of these used amoxicillin with metronidazole, one obtained azithromycin, and three used both antibiotics in their study groups. Conclusions: Both antibiotic regimens used in clinical trials (azithromycin and amoxicillin with metronidazole) as adjuvants to NSPT in patients with generalized chronic periodontitis, achieve better results in the clinical parameters of PD, CAL and BOP when compared to NSPT without use of antimicrobials The antibiotic therapy of amoxicillin with metronidazole, used in NSPT, achieves significantly better results than azithromycin according to clinical parameters of PD, BOP and CAL. It is suggested that future studies implement other antibiotic schemes to determine more effective alternatives as adjuvants in NSPT.
Objective: To establish whether amoxicillin plus metronidazole is more effective than azithromycin as adjunctive therapy during non-surgical periodontal treatment (NSPT) in patients diagnosed with generalized severe chronic periodontitis. Methodology: Systematic review of the literature according to the PRISMA protocol using the PubMed and Scielo databases. Clinical trials that have used amoxicillin with metronidazole, azithromycin or both as an adjuvant to NSPT, published in the last 10 years were included. The variables probing depth reduction (PD), bleeding on probing reduction (BOP) and clinical attachment level reduction (CAL) were used. Results: A total of 184 articles were reviewed, of which 7 met the eligibility criteria and were included in the review. Three of these used amoxicillin with metronidazole, one obtained azithromycin, and three used both antibiotics in their study groups. Conclusions: Both antibiotic regimens used in clinical trials (azithromycin and amoxicillin with metronidazole) as adjuvants to NSPT in patients with generalized chronic periodontitis, achieve better results in the clinical parameters of PD, CAL and BOP when compared to NSPT without use of antimicrobials The antibiotic therapy of amoxicillin with metronidazole, used in NSPT, achieves significantly better results than azithromycin according to clinical parameters of PD, BOP and CAL. It is suggested that future studies implement other antibiotic schemes to determine more effective alternatives as adjuvants in NSPT.
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Tesis (Cirujano Dentista)--Universidad Finis Terrae, 2022
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Santiago, Chile
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PERIODONTITIS, FARMACOLOGÍA DENTAL
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Atribución-NoComercial-CompartirIgual 3.0 Chile (CC BY-NC-SA 3.0 CL)