Table 1.
Clinical studies reporting on adjunctive topical and local therapy with different materials for the treatment of gingivitis and periodontitis.
| Author | Topical/Local Therapy Based on | Post Treatment Clinical Parameters | Outcomes/Conclusions |
|---|---|---|---|
| Pradeep et al. [28] | Simvastatin gel | Decrease in GBI—2.33 ± 0.80/Reduction in PPD—4.26 ± 1.59 mm/CAL gain—4.36 ± 1.92 mm | After 6 months, SRP with locally administered simvastatin gel gave significantly better clinical outcomes than SRP alone. |
| Guarnelli et al. [29] | Amine fluoride/Stannous fluoride (toothpaste and mouthrinse) | Decrease in PI *—Smoker (1.2)/Non-smoker (0.7)/Decrease in GI *—Smoker (0.2)/Non-smoker (0.3)/Reduction in PPD *—Smoker (0.5 mm)/Non-smoker (0.5 mm) | After 3 months, topical amine fluoride/stannous fluoride combination increased the efficacy of clinical outcomes compared with mechanical plaque control alone. |
| Flemmig et al. [30] | Moxifloxacin gel (0.125%, 0.4% and 1.25%) | Reduction in PPD—0.4% gel (1.5 ± 0.6 mm)/1.25% gel (1.2 ± 0.4 mm)/0.125% gel (1.1 ± 1.1 mm) | After 3 months, subgingival moxifloxacin 0.4% gel significantly reduced PPD compared with SRP alone. |
| Sapna and Vandana [31] | Hyaluronic acid gel (Gengigel® applied topical and intrasulcular) | Decrease in PI—0.72 ± 0.38/Decrease in GI—0.83 ± 0.32/Decrease in GBI—5.53 ± 1.91 | After 21 days, combined topical and intrasulcular hyaluronic acid gel administration significantly improved clinical outcomes and was equivalent to that of scaling alone. |
| Sharma and Pradeep [32] | Alendronate (1%) gel | Reduction in PPD—3.88 ± 1.39 mm/CAL gain—3.27 ± 1.11 | After 6 months, alendronate 1% gel when used as an adjunct to SRP significantly improves clinical periodontal outcomes and results in better bone fill in areas of bone destruction due to aggressive periodontitis. |
| Funosas et al. [33] | NSAID gel (aspirin 1%, ketoprofen 1%, ketoprofen 2%) | Decrease in PI—aspirin 1% (1.04 ± 0.84)/ketoprofen 1% (0.93 ± 0.80)/ketoprofen 2% (1.09 ± 0.74)/Decrease in GI—aspirin 1% (1.42 ± 0.76)/ketoprofen 1% (1.21 ± 0.83)/ketoprofen 2% (1.23 ± 0.77)/Reduction in PPD—aspirin 1% (1.26 ± 0.13 mm)/ketoprofen 1% (1.02 ± 0.21 mm)/ketoprofen 2% (1.08 ± 0.28 mm) | After 30 days, aspirin 1% gel administered subgingivally after SRP was the most effective NSAID gel in improving clinical outcomes. |
| Tonetti et al. [34] | Doxycycline gel (slow release formulation) | Reduction in PPD—0.11 ± 0.03 mm | After 3 months, subgingival scaling and administration of doxycycline gel resulted in significant reduction of PPD compared with scaling alone. |
| Chandra et al. [35] | Lycopene gel | After 3 months, locally administered lycopene gel significantly reduced gingival bleeding and PPD, and increased CAL. | |
| Madlena et al. [36] | Amine fluoride/Stannous fluoride (toothpaste and mouthrinse) | Decrease in PI—0.89 ± 0.15/Decrease in GI—1.05 ± 0.19 | After 4 weeks, use of amine fluoride/stannous fluoride as a chemical adjunct to mechanical plaque control was significantly beneficial in patients with orthodontic braces. |
| El-Sayed et al. [37] | Hyaluronic acid gel (Gengigel®) | Decrease in BOP *—0.50/Reduction in PPD *—3.0 mm/CAL gain *—3.5 mm | After 6 months, locally delivered hyaluronic acid gel significantly improves clinical outcomes of periodontal surgery. |
| Agarwal et al. [6] | Clarithromycin (0.5%) gel | Decrease in PI—1.47 ± 0.18/Decrease in GI—0.74 ± 0.08/Decrease in GBI—0.91 ± 0.10/Reduction in PPD—2.53 ± 0.16 mm/CAL gain—1.52 ± 0.15 | After 6 months, subgingival administration of clarithromycin 0.5% gel with SRP resulted in significantly enhanced clinical outcomes. |
| Patel et al. [38] | Ozonated olive oil | Decrease in PI—2.76 ± 0.16/Decrease in GI—2.17 ± 0.12/Decrease in GBI—4.15 ± 0.12 | After 8 weeks, SRP in combination with topically applied ozonated olive oil improves clinical periodontal outcomes, similar to results of chlorhexidine. |
| Pradeep et al. [1] | Chlorhexidine gel + Metronidazole gel | Decrease in PI—2.41 ± 0.10/Decrease in GI—1.36 ± 0.08/Decrease in bacterial population—26.6 ± 0.34 (×104 colonies) | After 6 months, topical application of a combination of chlorhexidine and metronidazole gel significantly improved clinical outcomes in gingivitis. |
| Pradeep et al. [11] | Metformin gel (0.5%, 1% and 1.5%) | Reduction in PPD—0.5% gel (2.97 ± 0.93 mm)/1% gel (4.0 ± 1.05 mm)/1.5% gel (3.8 ± 1.13 mm)/CAL gain—0.5% gel (2.23 ± 0.73 mm)/1% gel (3.83 ± 0.95 mm)/1.5% gel (3.6 ± 0.81 mm) | After 6 months, locally administered metformin gel (in differing concentrations) used as an adjunct with SRP significantly enhances periodontal clinical outcomes. |
| Chava and Vedula [39] | Green tea catechin gel | Decrease in GI—1.91 ± 0.20/Reduction in PPD—2.06 ± 0.07/CAL gain—2.1 ± 0.21 | After 4 weeks, use of locally administered green tea catechin gel as an adjunct to SRP significantly enhances clinical periodontal outcomes. |
| Anitha et al. [40] | Curcumin extract | Reduction in PPD—2.97 ± 0.12/CAL gain—2.79 ± 0.21 | After 30 days, locally administered curcumin extract as an adjunct to SRP significantly enhances clinical outcomes in comparison to chlorhexidine gel. |
| Priyanka et al. [41] | Satranidazole (3%) gel | Decrease in PI—0.18 ± 0.04/Decrease in GI—1.21 ± 0.06/Reduction in PPD—4.73 ± 0.33 mm/CAL gain—3.92 ± 0.29 mm | After 6 months, subgingivally administered satranidazole 3% gel as an adjunct with SRP significantly enhances periodontal clinical outcomes, in patients with type-2 diabetes. |
| Pradeep et al. [42] | Rosuvastatin (1.2%) gel | Decrease in GBI—3.71 ± 0.24/Reduction in PPD—4.04 ± 0.34 mm/CAL gain—4.2 ± 0.17 mm | After 6 months, subgingival delivery of rosuvastatin 1.2% gel as an adjunct with SRP resulted in significantly better clinical outcomes than SRP alone. |
| Pulikkotil and Nath [43] | Curcumin gel | Decrease in PI—0.42 ± 0.16/Decrease in GI—0.45 ± 0.31/Reduction in PPD—0.29 ± 0.67 mm | After 2 months, topically applied curcumin gel on gingivitis sites significantly improved clinical outcomes, equivalent to a combination of chlorhexidine and metronidazole gel, and better than application of chlorhexidine gel alone. |
| Kharaeva et al. [44] | Standardized fermented papaya gel | After 45 days, intragingival administration of papaya gel modulated the periodontal microenvironment resulting in synergistic antibacterial action with polymorphonuclear neutrophils, mediated through normalization of pro and anti-inflammatory cytokines. | |
| Bergamaschi et al. [3] | Metronidazole (15%) gel | Reduction in PPD *—1.8 mm/CAL gain *—1.9 mm | After 6 months, topically applied metronidazole (15%) gel as an adjunct to periodontal debridement was equally effective as orally administered metronidazole (750 mg) and better than periodontal debridement alone. |
| Martin et al. [2] | Essential oil gel (with antioxidants phloretin + ferulic acid) | Decrease in PI—0.08 ± 0.07/Decrease in GI—0.14 ± 0.04/Reduction in PPD—0.04 ± 0.03 mm | After 5 weeks, although there was no statistically significant improvement in clinical parameters, topical antioxidant gel application on the gingiva helped reduce inflammation among orthodontic patients. |
| Rayyan et al. [45] | Grape seed extract gel | Decrease in PI—0.75 ± 0.71/Decrease in GI—0.85 ± 0.77/Reduction in PPD—0.65 ± 0.98 mm | After 6 months, subgingivally administered grape seed extract gel, as an adjunct to SRP for periodontitis, significantly improved gingival parameters only. |
| Al-Shammari et al. [46] | Hyaluronic acid gel (Gengigel® applied subgingival) | Decrease in PI *—4.12/Decrease in GI *—4.11/Decrease in GBI *—4.04 | After 12 weeks, subgingival administration of hyaluronic acid gel as an adjunct to SRP results in significant improvement of clinical parameters. |
| Aslroosta et al. [47] | Erythropoietin gel | Decrease in PI—1.42 ± 0.22/Decrease in GI—1.62 ± 0.17/Decrease in GBI—1.87 ± 0.15/Reduction in PPD—1.77 ± 0.19 mm/CAL gain—1.70 ± 0.89 mm | After 3 months, locally administered erythropoietin gel as an adjunct to SRP results in significant improvement of gingival and periodontal clinical parameters except PI. |
GBI—Gingival bleeding index; PPD—Probing pocket depth; CAL—Clinical attachment level; SRP—Scaling and root planing; PI—Plaque index; GI—Gingival index; NSAID—Non-steroidal anti-inflammatory drug; BOP—Bleeding on probing; * Based on median values.