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Review

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

Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA
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Author to whom correspondence should be addressed.
Pharmaceutics 2025, 17(6), 697; https://doi.org/10.3390/pharmaceutics17060697 (registering DOI)
Submission received: 15 April 2025 / Revised: 22 May 2025 / Accepted: 23 May 2025 / Published: 26 May 2025

Abstract

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 Aloe vera. 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.
Keywords: local delivery; antimicrobials; photodynamic therapy; periodontitis local delivery; antimicrobials; photodynamic therapy; periodontitis

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MDPI and ACS Style

Boivin, W.G.; Cory, M.T.; Kormas, I.; Wolff, L.F. Adjunctive Local Agents to Subgingival Instrumentation in the Treatment of Periodontitis: A Review of Recent Clinical Trials and Future Perspectives. Pharmaceutics 2025, 17, 697. https://doi.org/10.3390/pharmaceutics17060697

AMA Style

Boivin WG, Cory MT, Kormas I, Wolff LF. Adjunctive Local Agents to Subgingival Instrumentation in the Treatment of Periodontitis: A Review of Recent Clinical Trials and Future Perspectives. Pharmaceutics. 2025; 17(6):697. https://doi.org/10.3390/pharmaceutics17060697

Chicago/Turabian Style

Boivin, William G., Maxwell T. Cory, Ioannis Kormas, and Larry F. Wolff. 2025. "Adjunctive Local Agents to Subgingival Instrumentation in the Treatment of Periodontitis: A Review of Recent Clinical Trials and Future Perspectives" Pharmaceutics 17, no. 6: 697. https://doi.org/10.3390/pharmaceutics17060697

APA Style

Boivin, W. G., Cory, M. T., Kormas, I., & Wolff, L. F. (2025). Adjunctive Local Agents to Subgingival Instrumentation in the Treatment of Periodontitis: A Review of Recent Clinical Trials and Future Perspectives. Pharmaceutics, 17(6), 697. https://doi.org/10.3390/pharmaceutics17060697

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