Adjunctive Local Agents to Subgingival Instrumentation in the Treatment of Periodontitis: A Review of Recent Clinical Trials and Future Perspectives

The purpose of this narrative review is to identify and present clinical trials published in the last five years on local delivery agents used as adjuncts to subgingival instrumentation in the non-surgical management of periodontitis. Epidemiological studies have shown that periodontitis is highly p...

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Main Authors: William G. Boivin, Maxwell T. Cory, Ioannis Kormas, Larry F. Wolff
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Pharmaceutics
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Online Access:https://www.mdpi.com/1999-4923/17/6/697
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author William G. Boivin
Maxwell T. Cory
Ioannis Kormas
Larry F. Wolff
author_facet William G. Boivin
Maxwell T. Cory
Ioannis Kormas
Larry F. Wolff
author_sort William G. Boivin
collection DOAJ
description The purpose of this narrative review is to identify and present clinical trials published in the last five years on local delivery agents used as adjuncts to subgingival instrumentation in the non-surgical management of periodontitis. Epidemiological studies have shown that periodontitis is highly prevalent in the general population. Treatment is usually based on mechanical removal of contaminants from the root surface followed by long-term supportive care, resulting in decreased occurrence of tooth loss. Clinical health is not always achieved at all sites, leading to research efforts by researchers to find adjunctive agents to help improve the periodontal condition. This review aims to present the most recent developments in local adjunctive agents for the non-surgical treatment of periodontitis. Therapies used included antimicrobial photodynamic therapy as well as antimicrobial and biomodulating compounds. A search in PubMed was conducted to identify the most recent randomized controlled trials relating to locally delivered adjunctive agents in periodontitis treatment beyond traditional therapies such as chlorhexidine, minocycline and doxycycline. Thirty-one articles published in the last five years were included. The most current evidence from human trials supports that, despite the high variability in experimental protocols, there may be a clinical benefit to antimicrobial photodynamic therapy and gels carrying sodium hypochlorite, melatonin, tea tree oil and <i>Aloe vera</i>. Most recently, advances in nanotechnology, including liposomes, present an avenue forward to potentially increase the effectiveness of current and future local delivery agents in the non-surgical treatment of periodontitis.
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spelling doaj-art-ce2ebe4caea1499ea7d5245374b50d1b2025-08-20T03:29:40ZengMDPI AGPharmaceutics1999-49232025-05-0117669710.3390/pharmaceutics17060697Adjunctive Local Agents to Subgingival Instrumentation in the Treatment of Periodontitis: A Review of Recent Clinical Trials and Future PerspectivesWilliam G. Boivin0Maxwell T. Cory1Ioannis Kormas2Larry F. Wolff3Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USADivision of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USADivision of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USADivision of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USAThe purpose of this narrative review is to identify and present clinical trials published in the last five years on local delivery agents used as adjuncts to subgingival instrumentation in the non-surgical management of periodontitis. Epidemiological studies have shown that periodontitis is highly prevalent in the general population. Treatment is usually based on mechanical removal of contaminants from the root surface followed by long-term supportive care, resulting in decreased occurrence of tooth loss. Clinical health is not always achieved at all sites, leading to research efforts by researchers to find adjunctive agents to help improve the periodontal condition. This review aims to present the most recent developments in local adjunctive agents for the non-surgical treatment of periodontitis. Therapies used included antimicrobial photodynamic therapy as well as antimicrobial and biomodulating compounds. A search in PubMed was conducted to identify the most recent randomized controlled trials relating to locally delivered adjunctive agents in periodontitis treatment beyond traditional therapies such as chlorhexidine, minocycline and doxycycline. Thirty-one articles published in the last five years were included. The most current evidence from human trials supports that, despite the high variability in experimental protocols, there may be a clinical benefit to antimicrobial photodynamic therapy and gels carrying sodium hypochlorite, melatonin, tea tree oil and <i>Aloe vera</i>. Most recently, advances in nanotechnology, including liposomes, present an avenue forward to potentially increase the effectiveness of current and future local delivery agents in the non-surgical treatment of periodontitis.https://www.mdpi.com/1999-4923/17/6/697local deliveryantimicrobialsphotodynamic therapyperiodontitis
spellingShingle William G. Boivin
Maxwell T. Cory
Ioannis Kormas
Larry F. Wolff
Adjunctive Local Agents to Subgingival Instrumentation in the Treatment of Periodontitis: A Review of Recent Clinical Trials and Future Perspectives
Pharmaceutics
local delivery
antimicrobials
photodynamic therapy
periodontitis
title Adjunctive Local Agents to Subgingival Instrumentation in the Treatment of Periodontitis: A Review of Recent Clinical Trials and Future Perspectives
title_full Adjunctive Local Agents to Subgingival Instrumentation in the Treatment of Periodontitis: A Review of Recent Clinical Trials and Future Perspectives
title_fullStr Adjunctive Local Agents to Subgingival Instrumentation in the Treatment of Periodontitis: A Review of Recent Clinical Trials and Future Perspectives
title_full_unstemmed Adjunctive Local Agents to Subgingival Instrumentation in the Treatment of Periodontitis: A Review of Recent Clinical Trials and Future Perspectives
title_short Adjunctive Local Agents to Subgingival Instrumentation in the Treatment of Periodontitis: A Review of Recent Clinical Trials and Future Perspectives
title_sort adjunctive local agents to subgingival instrumentation in the treatment of periodontitis a review of recent clinical trials and future perspectives
topic local delivery
antimicrobials
photodynamic therapy
periodontitis
url https://www.mdpi.com/1999-4923/17/6/697
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