Antibiotherapy in the treatment of diseases affecting the periodontium. Bibliographic review

An ideal antimicrobial for the prevention and treatment of periodontal diseases should be specific for key pathogens, non-toxic, and capable of reaching effective concentrations in periodontal tissues. The aim of this study was to analyze the mechanisms of action and clinical use of antimicrobial agents in the treatment of lesions affecting periodontal tissues. An exhaustive search was conducted in scientific databases, selecting articles published between 2019 and 2024 that met defined inclusion and exclusion criteria, allowing the analysis of 15 relevant studies. The results highlight that the combination of amoxicillin and metronidazole achieves significant improvements in periodontal probing depth, clinical attachment level, and bleeding on probing, although it is not superior to surgical treatments with the same agents. Systemic antibiotics offer benefits in cases of chronic and aggressive periodontitis, but their impact on systemic inflammatory biomarkers is limited. Additionally, the use of local antibiotics in recurrent cases can be effective and minimize the adverse effects associated with systemic administration. The study's conclusions emphasize that mechanical treatments are essential and that antimicrobial agents should be used as adjuncts based on microbiological analysis. The indiscriminate use of antibiotics is associated with bacterial resistance, reinforcing the need for well-defined protocols to maximize clinical benefits