Systemic Antibiotics as Adjuncts in Periodontal Therapy for Stage III and Stage IV Periodontitis: An Umbrella Review Aligned with the 2018 World Workshop Classification, with AMSTAR-2 Critical Appraisal.
An umbrella review of systematic reviews found moderate evidence supporting adjunctive amoxicillin plus metronidazole with mechanical therapy for severe periodontitis, though azithromycin showed insufficient evidence; findings support selective rather than routine antibiotic use.
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