In this systematic review, we assessed the effectiveness of systemic antibiotics as an adjunctive therapy to mechanical debridement in improving inflammatory systemic biomarkers, as compared to mechanical debridement alone, among adults with chronic periodontitis. We searched relevant electronic databases for eligible randomized controlled trials. Two review authors independently screened, extracted data, and assessed risk of bias. We conducted meta-analysis, assessed heterogeneity, and assessed certainty of evidence using GRADEPro software. We included 19 studies (n = 1350 participants), representing 18 randomized controlled trials and found very little or no impact of antibiotics on inflammatory biomarkers. A meta-analysis of eight studies demonstrated a mean reduction of 0.26 mm in the periodontal pockets at three months (mean difference [MD] −0.26, 95%CI: −0.36 to −0.17, n = 372 participants, moderate certainty of evidence) in favor of the antibiotics. However, results from five studies reporting clinical attachment level (mm) yielded little or no difference at three months (MD −0.16, 95% CI: −0.35 to 0.03, n = 217 participants) between antibiotic and placebo groups. There is little or no evidence that adjunctive systemic antibiotics therapy improves inflammatory systemic biomarkers, compared to mechanical debridement alone, among adults with chronic periodontitis.

中文翻译：

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机械性清创术与抗生素治疗慢性牙周炎：对全身生物标志物的影响-系统评价。

在这项系统评价中，我们评估了在慢性牙周炎成人中，与单纯机械清创相比，全身抗生素作为机械清创的辅助疗法在改善炎症性全身生物标志物方面的有效性。我们在相关的电子数据库中搜索了合格的随机对照试验。两名评价作者独立筛选，提取数据并评估偏倚风险。我们进行了荟萃分析，评估了异质性，并使用GRADEPro软件评估了证据的确定性。我们纳入了19项研究（n = 1350名参与者），代表18项随机对照试验，发现抗生素对炎症生物标志物的影响很小或没有影响。对八项研究的荟萃分析显示平均减少了0。三个月时在牙周袋中长26 mm（平均差[MD] -0.26，95％CI：-0.36至-0.17，n = 372名参与者，证据的中度确定性），有利于抗生素。然而，来自五项研究的结果报告了抗生素组与安慰剂组在三个月内的临床依从水平（mm）几乎没有差异（MD -0.16，95％CI：-0.35至0.03，n = 217名受试者）。几乎没有证据表明，与单纯机械清创术相比，在慢性牙周炎的成年人中，辅助全身性抗生素治疗可改善炎症性全身生物标志物。-0.35至0.03，n = 217名参与者）在抗生素和安慰剂组之间。几乎没有证据表明，与单纯机械清创术相比，在慢性牙周炎的成年人中，辅助全身性抗生素治疗可改善炎症性全身生物标志物。-0.35至0.03，n = 217名参与者）在抗生素和安慰剂组之间。几乎没有证据表明，与单纯机械清创术相比，在慢性牙周炎的成年人中，辅助全身性抗生素治疗可改善炎症性全身生物标志物。