[The use of antibiotics in periodontics. A review of the literature].

Since periodontal diseases are mainly of bacterial origin, the use of antibiotics could seem justified for their treatment. Numerous studies, however, have shown that these drugs are not a first choice treatment for acute and chronic periodontitis. Chemotherapy can represent a valuable adjunct to routine mechanical debridement, particularly for adult recurrent periodontitis, juvenile periodontitis and rapidly progressive periodontitis. Furthermore, prophylactic chemotherapy should be provided for patients at risk with systemic diseases, notably when congenital or acquired valvular heart defects are present. For the treatment of adult recurrent periodontitis, the most appropriate systematic drugs are, presently, tetracyclines or imidazoles. Juvenile periodontitis can be treated with the help of tetracyclines and rapidly progressive periodontitis with imidazoles. As for high risk patients, the use of various penicillins is mandatory. A decision to use antibiotics must be made only after due consideration of their potential disadvantages. One should also remember that the possible positive or negative effects of antibiotics upon the host defence mechanisms are for the moment unknown.