Non-synthetic vs synthetic local drug delivery agents for the treatment of periodontitis in adults: a systematic review and meta-analysis protocol.

OBJECTIVE

The objective of this review is to evaluate the effectiveness of non-synthetic local drug-delivery agents vs synthetic local drug-delivery agents on periodontal parameters when used as an adjunct to scaling and root planing in adult patients with periodontitis.

INTRODUCTION

Local delivery of synthetic drugs subgingivally along with conventional scaling and root planing is beneficial to control periodontitis. Over the years, various naturally derived local drug-delivery agents have also been studied for their effect on periodontal parameters when delivered subgingivally in patients with periodontitis. There is growing interest in biocompatible, potentially safer, and more cost-effective alternatives to synthetic agents, but there is also a lack of systematic comparisons between natural and synthetic formulations.

ELIGIBILITY CRITERIA: Randomized controlled trials, quasi-experimental studies, and non-randomized controlled trials that involve adults (≥18 years) diagnosed with periodontitis, treated with scaling and root planing and adjunctive local drug-delivery agent will be eligible for inclusion. Eligible studies must compare non-synthetic vs synthetic drug-delivery agents.

METHODS

Searches will be conducted via MEDLINE (EBSCOhost), CINAHL (EBSCOhost), Cochrane CENTRAL, Scopus, Dentistry and Oral Sciences Source, Web of Science Core Collection, and gray literature sources. Articles in any language from database inception onward will be considered. Two reviewers will independently screen the titles and abstracts, and select full texts for inclusion. Critical appraisal of included studies will be done by 2 reviewers independently using standardized JBI checklists. If sufficient data are present, studies will be pooled using meta-analysis, and the results will be discussed narratively. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach will be used to assess certainty in the findings.

REVIEW REGISTRATION: PROSPERO CRD42023469354.