Terapias locais como adjuvantes a raspagem e alisamento radicular no tratamento periodontal não cirúrgico da periodontite agressiva: uma revisão sistemática

Abstract

Aim: Scaling and root planing is currently the standard initial treatment of periodontal diseases. Local therapies been used as an adjuvant in the treatment and preventive therapy of periodontitis. The aim of this review is identifying if local therapy as an adjuvant to scaling and root planing lead to improvements in the periodontal clinical parameters in patients with aggressive periodontitis. Materials and Methods: Seven databases: Pubmed (Medline), Lilacs, Web of Science, BBO, Scopus, SciELO and The Cochrane Library were searched up to until August of 2018. Randomized clinical trials using local delivery systems as an adjunct to scaling and root planing in patients with aggressive periodontitis with a follow-up period of more than one month were included in the study. Results: A total of 2942 studies were found, but only 6 met all the selection criteria and were included in the qualitative analysis. Simvastatin 1.2 mg and Alendronate 10mg / ml gel were the substances that presented better benefits when compared with the control group. While substances such as 1% chlorhexidine, 25% metronidazole gel, 10% doxycycline gel, 40% tetracycline showed no improvement when compared to the control group. The studies showed a methodological heterogeneity, with different irrigating substances, protocols and forms of application used. Conclusion: Although this review has shown the benefits of local release therapies for Alendronate and Simvastatin gel as an adjuvant to the nonsurgical treatment of aggressive periodontitis, but due to insufficient evidence, it was not possible to prove the benefits / benefits of local therapy efficacy as adjuvant to the standard treatment of aggressive periodontitis. Further welldesigned randomized clinical trials are required to confirm the efficacy of this therapy.