Title: Local tetracycline is an effective adjunct in the treatment of chronic periodontitis
Abstract: Data sources Medline provided the primary data source and references lists from the identified papers were reviewed to source additional studies. Study selection Studies published in English prior to December 2001 were included if they were primary randomised controlled trials; were conducted in human subjects; examined the effects of local tetracycline in various forms in reducing probing depth (PD) and/or improving attachment level (AL); and they reported mean and measures of variance of PD and AL. Data extraction and synthesis The methods and results section of each article were read and scored by two independent readers. Meta-analyses were performed on the basis of baseline PD, type of antibiotic used, and experimental and control regimens. A random-effects model was used to combine data. Results A total of 29 studies met the inclusion criteria and were included in the meta-analyses. The quality assessment showed the studies to be of variable quality, with many failing to report relevant information. A significant mean reduction in PD was observed when tetracycline was used as an adjunct to scaling and root planing (SRP; mean difference at 12 weeks, 0.69 mm; 95% confidence interval, 0.57–0.81; P<0.001). Tetracycline alone did not result in a statistically significant clinical improvement compared with SRP but did perform better than placebo for people whose PD was >6 mm after 4 (P<0.001) and 8 (P=0.005) weeks. Conclusions The meta-analyses demonstrated that statistically significant, although not clinically substantial, improvement could be achieved in cases of chronic periodontitis when local delivery of tetracycline was used as an adjunct to scaling and root planing.