Highlights on role of antibiotics in periodontics

Periodontal treatment aims at restoring a micro biota compatible with periodontal health. Scaling and root planing can be classified as 'THE GOLD STANDARD” of periodontal care and has been demonstrated to be successful in order to maintain periodontal health for more than 20 years. Whereas periodontal antibiotic therapy aims to reinforce mechanical periodontal treatment and to support host defense system in overcoming the infection by killing sub gingival pathogens that remains after conventional mechanical periodontal therapy. A number of key elements need to be considered such as the anti-biofilm strategies, drug resistance in biofilm, various routes of antibiotic administration, its efficacy, sequencing of antibiotics while administering antibiotics for periodontitis. Pencillin was the first antibiotic systemically administered; historical background of antibiotics is reviewed here. Earlier choice was based exclusively on empiric evidence but with time tetracycline, metronidazole and beta lactams are among the most widely used agents for treating periodontal condition. This review henceforth attempts to describe the rationale of antibiotics in periodontal therapy. There is also a collection of data from scientific papers clinically relevant to the periodontitis providing description of nature of biofilms in general, oral biofilms in particular as well as approaches to their control, behavior of antibiotics in oral biofilm, potential of systemic and locally applied antibiotic therapy to control the periodontopathic microbiota.