Efficacy Of Minocycline Hydrochloride Combined With Flap Surgery For Chronic Periodontitis:a Meta-analysis

After mechanical debridement in patients with chronic periodontitis,more than 6mm deep in the periodontal pockets,which often requires further surgical treatment to eliminate periodontal pockets.Flap surgery is one of the most common operation in periodontal surgery,root surface debridement under direct vision can completely removed the plaque and formed a smooth surface of the root,it would be helpful to control of periodontal inflammation.However,the mechanical debridement will produce a smear layer on the root surface,which is not conducive to the formation of the new attachment of the root surface and the healing of periodontal tissue.It has become a key link in periodontal tissue regeneration after the treatment of root surface treatment with chemical treating agent.Minocycline hydrochloride is antibacterial agent and the pH value of acid,has a doublecharacteristics of antibiotics and root surface treatment agent,widely used in the clinic,but its clinical efficacy has always been in doubt.In this paper,the method of evidence-based medicine is used for Meta analysis to evaluate its curative effect and provide reference for clinic.ObjectiveTo systematically evaluate the efficacy of 2% minocycline hydrochloride as root conditioning on periodontal flap surgery,and to provide basis for treatment of chronic periodontitis.MethodsWe searched CNKI,VIP,Wanfang,Chinese biomedical literature database,PubMed,ScienceDirect and Embase database from inception to July,2017.Two reviewers independently screened literature,extracted data and evaluated the bias risk of included studies.Then meta-analysis was performed using RevMan 5.3 software.ResultsA total of 7 RCTs involving 217 patients were included.Meta analysis showed that compared with flap surgery only(FO),the minocycline ointment in association with flap surgery(FM)showed a significantly decrease on probing depth(at 3 months:MD=-0.55,95%CI:-0.84~0.26,P=0.0002;and 6 months:MD=-0.62,95%CI:-1.04~0.21,P=0.003)and plaque index(at 3 months:MD=-0.08,95%CI:-0.15~-0.01,P=0.03),the difference between two group was statistically significant(P <0.05).And the clinical attachment loss(CAL)gain(MD=-0.21,95%CI:-0.47~0.04,P=0.10)of the difference was not statistically significant after 3 months(P>0.05),but the of CAL gain was significantly improved by minocycline hydrochloride combined with flap therapy.ConclusionPeriodontal flap surgery combined with minocycline therapy for chronic periodontitis is effective for probing depth reduction and improving inflammationl.