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In particular, it addresses whether their use can improve the results of nonsurgical mechanical therapy in mild\u2010to\u2010moderate forms of the disease. Large numbers of randomized clinical trials and systematic reviews with meta\u2010analyses have clearly established that adjunctive systemic antibiotics, combined with mechanical debridement, offer clinical improvements additional to those obtained with scaling and root planing alone. These effects are more pronounced in aggressive periodontitis and in initially deep pockets, whereas more limited additional improvements, of 0.3\u00a0mm for additional pocket reduction and 0.2\u00a0mm for additional clinical attachment gain, have been documented for moderately deep sites (4\u20136\u00a0mm) in patients with chronic periodontitis. The marginal clinical benefit in patients with moderate disease has to be balanced against possible side effects. Notably, it has to be realized that an increasing number of warnings have been articulated against the unrestricted use of antibiotics in treating periodontal diseases because of the emerging global public health issue of bacterial resistance. The effects of the adjunctive local administration of antimicrobials have also been very well documented in several systematic reviews. Overall, in persistent or recurrent localized deep sites, the application of antimicrobials by sustained\u2010delivery devices may offer a benefit of an additional 0.4\u00a0mm in pocket depth reduction and 0.3\u00a0mm in clinical attachment level gain. In conclusion, the slight additional benefits of adjunctive antimicrobials, which were shown for moderate forms of periodontitis, have to be balanced against their side effects and therefore their prescription should be limited as much as possible.<\/jats:p>","DOI":"10.1111\/prd.12121","type":"journal-article","created":{"date-parts":[[2016,4,5]],"date-time":"2016-04-05T09:33:53Z","timestamp":1459848833000},"page":"82-112","source":"Crossref","is-referenced-by-count":258,"title":["Antibiotics\/antimicrobials: systemic and local administration in the therapy of mild to moderately advanced 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