Systemic doxycycline as an adjunct to nonsurgical periodontal therapy in diabetic patients with periodontitis: a systematic review and meta-analysis
BackgroundRecent studies that investigated the effects of systemic doxycycline as an adjuvant to scale and root planing (SRP) in the treatment of diabetic periodontitis have yielded controversial results. The aim of this meta-analysis is to evaluate the effect of systemic doxycycline as an adjunct t...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Physiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphys.2024.1479152/full |
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| author | Zheng Zhang Zheng Zhang Zhenyu Zhang Guoquan Zhang |
| author_facet | Zheng Zhang Zheng Zhang Zhenyu Zhang Guoquan Zhang |
| author_sort | Zheng Zhang |
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| description | BackgroundRecent studies that investigated the effects of systemic doxycycline as an adjuvant to scale and root planing (SRP) in the treatment of diabetic periodontitis have yielded controversial results. The aim of this meta-analysis is to evaluate the effect of systemic doxycycline as an adjunct to SRP against SRP alone for improving clinical outcomes of periodontitis in diabetic individuals.MethodsA systematic literature search was performed using PubMed, Cochrane library, China National Knowledge Infrastructure (CNKI), and VIP Data from the beginning of the database until March 2024. For probing depth (PD), clinical attachment level (CAL), plaque index (PI), gingival index (GI), and bleeding on probing (BOP), mean difference (MD) and the 95% confidence interval (CI) were computed. Heterogeneity was assessed using the Q test and the I2 statistic. Evaluation of publication bias was conducted using Egger’s and Begg’s tests.ResultsA total of 12 articles were included for meta-analysis. No statistically significant difference was indicated in the improvement of PD, CAL, PI and GI between a treatment group receiving SRP combined with short-term antimicrobial dose doxycycline and controls receiving SRP alone. However, short-term antimicrobial dose doxycycline plus SRP significantly reduced BOP by 8.14% (95%CI 2.23–14.05) at 3 months. Furthermore, after the adjunctive use of long-term sub-antimicrobial dose doxycycline, significant reductions in GI (MD: 0.72, 95% CI: 0.34–1.10) and BOP (MD: 12.8, 95% CI: 0.24–25.36) were observed at 3 months. The robustness of the results was further confirmed by sensitivity analysis, despite the truth that significant heterogeneity was found among the included studies.ConclusionGingival inflammation in diabetic patients can be reduced more successfully by SRP combined with systemic doxycycline than by SRP alone, but this is insufficient in preventing periodontal tissue destruction. |
| format | Article |
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| institution | Kabale University |
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| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Physiology |
| spelling | doaj-art-1fc3e1b0905f4924a6141adc9d5c928c2025-01-22T07:11:09ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2025-01-011510.3389/fphys.2024.14791521479152Systemic doxycycline as an adjunct to nonsurgical periodontal therapy in diabetic patients with periodontitis: a systematic review and meta-analysisZheng Zhang0Zheng Zhang1Zhenyu Zhang2Guoquan Zhang3Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin, ChinaTianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin, ChinaThe School of Pharmacy, Jiamusi University, Jiamusi, ChinaJitang College, North China University of Science and Technology, Tangshan, ChinaBackgroundRecent studies that investigated the effects of systemic doxycycline as an adjuvant to scale and root planing (SRP) in the treatment of diabetic periodontitis have yielded controversial results. The aim of this meta-analysis is to evaluate the effect of systemic doxycycline as an adjunct to SRP against SRP alone for improving clinical outcomes of periodontitis in diabetic individuals.MethodsA systematic literature search was performed using PubMed, Cochrane library, China National Knowledge Infrastructure (CNKI), and VIP Data from the beginning of the database until March 2024. For probing depth (PD), clinical attachment level (CAL), plaque index (PI), gingival index (GI), and bleeding on probing (BOP), mean difference (MD) and the 95% confidence interval (CI) were computed. Heterogeneity was assessed using the Q test and the I2 statistic. Evaluation of publication bias was conducted using Egger’s and Begg’s tests.ResultsA total of 12 articles were included for meta-analysis. No statistically significant difference was indicated in the improvement of PD, CAL, PI and GI between a treatment group receiving SRP combined with short-term antimicrobial dose doxycycline and controls receiving SRP alone. However, short-term antimicrobial dose doxycycline plus SRP significantly reduced BOP by 8.14% (95%CI 2.23–14.05) at 3 months. Furthermore, after the adjunctive use of long-term sub-antimicrobial dose doxycycline, significant reductions in GI (MD: 0.72, 95% CI: 0.34–1.10) and BOP (MD: 12.8, 95% CI: 0.24–25.36) were observed at 3 months. The robustness of the results was further confirmed by sensitivity analysis, despite the truth that significant heterogeneity was found among the included studies.ConclusionGingival inflammation in diabetic patients can be reduced more successfully by SRP combined with systemic doxycycline than by SRP alone, but this is insufficient in preventing periodontal tissue destruction.https://www.frontiersin.org/articles/10.3389/fphys.2024.1479152/fulldoxycyclineperiodontitisdiabetes mellitusmeta-analysisperiodontal therapy |
| spellingShingle | Zheng Zhang Zheng Zhang Zhenyu Zhang Guoquan Zhang Systemic doxycycline as an adjunct to nonsurgical periodontal therapy in diabetic patients with periodontitis: a systematic review and meta-analysis Frontiers in Physiology doxycycline periodontitis diabetes mellitus meta-analysis periodontal therapy |
| title | Systemic doxycycline as an adjunct to nonsurgical periodontal therapy in diabetic patients with periodontitis: a systematic review and meta-analysis |
| title_full | Systemic doxycycline as an adjunct to nonsurgical periodontal therapy in diabetic patients with periodontitis: a systematic review and meta-analysis |
| title_fullStr | Systemic doxycycline as an adjunct to nonsurgical periodontal therapy in diabetic patients with periodontitis: a systematic review and meta-analysis |
| title_full_unstemmed | Systemic doxycycline as an adjunct to nonsurgical periodontal therapy in diabetic patients with periodontitis: a systematic review and meta-analysis |
| title_short | Systemic doxycycline as an adjunct to nonsurgical periodontal therapy in diabetic patients with periodontitis: a systematic review and meta-analysis |
| title_sort | systemic doxycycline as an adjunct to nonsurgical periodontal therapy in diabetic patients with periodontitis a systematic review and meta analysis |
| topic | doxycycline periodontitis diabetes mellitus meta-analysis periodontal therapy |
| url | https://www.frontiersin.org/articles/10.3389/fphys.2024.1479152/full |
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