Evidence map›Paper›PMID 39229981›Full record

SynthesisCurrent diabetes reviews2025

Efficacy of Adjunctive Local Antimicrobials to Non-Surgical Periodontal Therapy in Pocket Reduction and Glycemic Control of Patients with Type 2 Diabetes: A Network Meta-Analysis.

Domitilla Marchiori Sant'Anna Leal de Oliveira, Ana Luiza Magalhães de Souza, Getulio da Rocha Nogueira Filho, Carolina Castro Martins-Pfeifer, Cristine Miron Stefani

Abstract readNetwork Meta-AnalysisSystematic Review
In one paragraph

Synthesis in Current diabetes reviews, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Review
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Domitilla Marchiori Sant'Anna Leal de OliveiraSchool of Dentistry, University of Brasilia, Brasilia, Brazil.ORCID 0000-0003-2462-6780
Ana Luiza Magalhães de SouzaSchool of Dentistry, University of Brasilia, Brasilia, Brazil.
Getulio da Rocha Nogueira FilhoPrivate Practice, Dunedin, New Zealand.ORCID 0000-0002-3847-5090
Carolina Castro Martins-PfeiferSchool of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil.ORCID 0000-0001-9072-3226
Cristine Miron StefaniSchool of Dentistry, University of Brasilia, Brasilia, Brazil.ORCID 0000-0003-4712-9779

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis network meta-analysis [NMA] investigated the efficacy of adjunctive use of subgingivally delivered antimicrobials to non-surgical periodontal therapy [NSPT] in the glycemic control and periodontal pocket depth (PPD) reduction in patients with type 2 diabetes (T2D).

methodsSeven databases, grey literature, and registry platforms were searched up to February 2024 to identify randomized clinical trials (RCT) fulfilling the eligibility criteria. The risk of bias was assessed through Cochrane's tool (RoB 2). Two frequentist NMA were performed using a random-effects model to calculate mean differences (MD) as an effect measure and to quantitatively evaluate the glycated hemoglobin (HbA1c) and PPD. The certainty of evidence was assessed through the GRADE approach in a partially contextualized framework for interpreting results. Ten RCTs were included.

resultsIn total, 261 patients were treated with eight different local antimicrobials adjuvants to NSPT (azithromycin gel, clarithromycin gel, tetracycline fiber or ointment, chlorhexidine gel, doxycycline nanospheres, minocycline gel, and satranidazole gel), while 249 patients received NSPT alone or associated to placebo. Considering PPD reduction (8 included studies), the best results were found after six months for satranidazole gel (MD -2.64 mm; 95%CI -3.56, -1.72; moderate evidence certainty). For HbA1c control (7 included studies), doxycycline gel (MD - 0.80%; 95%CI -1.70, 0.10), chlorhexidine gel (MD -0.68%; 95%CI -1.34, -0.02), and tetracycline fiber (MD -0.62%; 95%CI -0.85, -0.39) showed promising results after three months (low evidence certainty).

conclusionThe adjunctive use of satranidazole gel probably reduces PPD after a 6-month follow-up, while doxycycline gel, chlorhexidine gel, and tetracycline fiber may decrease HbA1c values in patients with T2D and periodontitis treated with NSPT after a 3-month follow up.

Indexed as

Anti-Infective Agents, LocalDiabetes Mellitus, Type 2Glycemic ControlPeriodontal PocketBlood GlucoseGlycated HemoglobinHumansRandomized Controlled Trials as TopicTreatment OutcomeAnti-Infective Agents, LocalBlood GlucoseGlycated HemoglobinAntimicrobialsnetwork meta-analysis.non-surgical periodontal therapyperiodontitissystematic reviewtype 2 diabetes mellitus

Identifiers

PMID39229981
PMCPMC12082567

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.