Findings

What do systematic reviews say?

592 questions · 793 findings · 32 reviews · Periodontology

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No studies found 148 · 18.7%GRADE not reported 429 · 54.1%Very low 137 · 17.3%Low 53 · 6.7%Moderate 14 · 1.8%High 12 · 1.5%

Periodontal treatment: scaling and root planing (SRP) plus advice vs Community care: advice only

All‐cause death · Patients with cardiovascular disease and chronic periodontitis

The review found no eligible studies for this question.

1 finding from 1 review

Periodontal therapy for primary or secondary prevention of cardiovascular disease in people with periodontitis 2022 · Cochrane All outcomes
SoF row 'All-cause death': Outcome not reported. Results 2.1.1: Not reported.
0 studies
No studies found

Periodontal treatment (subgingival instrumentation, with or without antimicrobials/surgery) vs usual care or no treatment

Percentage of bleeding on probing (BOP) · People with diabetes mellitus (type 1 or type 2, mostly type 2) and periodontitis, at least 16 years of age

Periodontal treatment (subgingival instrumentation, with or without… led to lower bleeding on probing (BOP) compared with no active intervention/usual care; GRADE not reported.

1 finding from 1 review

Treatment of periodontitis for glycaemic control in people with diabetes mellitus 2022 · Cochrane All outcomes
3-4 months
MD -15.56 [-21.77, -9.36]
14 studies
GRADE not reported

Full-mouth disinfection (FMD): scaling/root planing (subgingival instrumentation) of all quadrants within 24 hours plus adjunctive antiseptic (chlorhexidine) treatments (rinsing, pocket irrigation, tongue/tonsil brushing) vs Quadrant scaling and root planing (control): SRP of each quadrant in separate sessions at least one week apart

Change in bleeding on probing (BOP) · Adults with a clinical diagnosis of (chronic) periodontitis (1999 classification); studies of aggressive periodontitis, systemic disorders…

It is very uncertain whether full-mouth disinfection (FMD): scaling/root planing (subgingival… changes change in bleeding on probing (BOP) compared with quadrant scaling and root planing (control): SRP of each quadrant in… (very low certainty).

1 finding from 1 review

Full‐mouth treatment modalities (within 24 hours) for periodontitis in adults 2022 · Cochrane All outcomes
6 to 8 months (SoF); similar at 3 to 4 months
MD 9.54 [-2.24, 21.32]
4 studies · 92 participants
Very low

Amoxicillin + metronidazole + SRP vs Supragingival scaling (plus placebo)

All‐cause death · People with periodontitis and metabolic syndrome (no CVD; primary prevention)

It is very uncertain whether scaling and root planing (SRP) plus antibiotics (amoxicillin and… changes all-cause death compared with supragingival scaling (plus placebo) (very low certainty).

1 finding from 1 review

Periodontal therapy for primary or secondary prevention of cardiovascular disease in people with periodontitis 2022 · Cochrane All outcomes
12 months
Peto OR 7.48 [0.15, 376.98]
1 study · 165 participants
Very low

Periodontal treatment: scaling and root planing (SRP) plus advice vs Community care: advice only

Adverse events due to periodontal therapy · Patients with cardiovascular disease and chronic periodontitis

1 finding from 1 review

Periodontal therapy for primary or secondary prevention of cardiovascular disease in people with periodontitis 2022 · Cochrane All outcomes
6 to 25 months
Adverse events: because of variable follow-up (6 to 25 months) and almost 90% loss to follow-up by one year, results were not considered useful for analysis; uncertain whether adverse events are more likely with either…
1 study · 303 participants
GRADE not reported

Full-mouth scaling (FMS): scaling/root planing (subgingival instrumentation) of all quadrants within 24 hours, without antiseptic vs Full-mouth disinfection (FMD): scaling/root planing (subgingival instrumentation) of all quadrants within 24 hours plus adjunctive antiseptic (chlorhexidine) treatments (rinsing, pocket irrigation, tongue/tonsil brushing)

Change in probing pocket depth (PPD) · Adults with a clinical diagnosis of (chronic) periodontitis (1999 classification); studies of aggressive periodontitis, systemic disorders…

Full-mouth scaling (FMS): scaling/root planing (subgingival… showed no clear difference in change in probing pocket depth (PPD) compared with full-mouth disinfection (FMD): scaling/root planing (subgingival… (low certainty).

1 finding from 1 review

Full‐mouth treatment modalities (within 24 hours) for periodontitis in adults 2022 · Cochrane All outcomes
6 to 8 months (SoF); similar at 3 to 4 months
MD -0.11 [-0.30, 0.07]
4 studies · 112 participants
Low

Periodontal treatment (subgingival instrumentation, with or without antimicrobials/surgery) vs usual care or no treatment

Diabetic complications · People with diabetes mellitus (type 1 or type 2, mostly type 2) and periodontitis, at least 16 years of age

The review found no eligible studies for this question.

1 finding from 1 review

Treatment of periodontitis for glycaemic control in people with diabetes mellitus 2022 · Cochrane All outcomes
3-4 months
Included studies did not report data on diabetic complications (some reported medication changes only)
0 studies
No studies found

Periodontal treatment (subgingival instrumentation, with or without antimicrobials/surgery) vs usual care or no treatment

Adverse effects of treatment · People with diabetes mellitus (type 1 or type 2, mostly type 2) and periodontitis, at least 16 years of age

1 finding from 1 review

Treatment of periodontitis for glycaemic control in people with diabetes mellitus 2022 · Cochrane All outcomes
3-4 months
SoF comment: insufficient evidence to determine whether SRP for glycaemic control is associated with any harms; most studies did not evaluate adverse effects. Where reported (e.g. D'Aiuto 2018) serious adverse events…
Studies not reported
GRADE not reported

Full-mouth disinfection (FMD): scaling/root planing (subgingival instrumentation) of all quadrants within 24 hours plus adjunctive antiseptic (chlorhexidine) treatments (rinsing, pocket irrigation, tongue/tonsil brushing) vs Quadrant scaling and root planing (control): SRP of each quadrant in separate sessions at least one week apart

Attachment change · Adults with a clinical diagnosis of (chronic) periodontitis (1999 classification); studies of aggressive periodontitis, systemic disorders…

Full-mouth disinfection (FMD): scaling/root planing (subgingival… showed no clear difference in change in clinical attachment level (CAL) compared with quadrant scaling and root planing (control): SRP of each quadrant in… (low certainty).

1 finding from 1 review

Full‐mouth treatment modalities (within 24 hours) for periodontitis in adults 2022 · Cochrane All outcomes
6 to 8 months (SoF); similar at 3 to 4 months
MD 0.07 [-0.11, 0.24]
6 studies · 214 participants
Low

Periodontal treatment: scaling and root planing (SRP) plus advice vs Community care: advice only

Serum high-sensitivity C-reactive protein (hs-CRP) · Patients with cardiovascular disease and chronic periodontitis

1 finding from 1 review

Periodontal therapy for primary or secondary prevention of cardiovascular disease in people with periodontitis 2022 · Cochrane All outcomes
12 months
Serum hs-CRP tested at one year; as loss to follow-up was almost 90%, data not considered useful for analysis (no usable estimate).
1 study · 37 participants
GRADE not reported

Full-mouth scaling (FMS): scaling/root planing (subgingival instrumentation) of all quadrants within 24 hours, without antiseptic vs Full-mouth disinfection (FMD): scaling/root planing (subgingival instrumentation) of all quadrants within 24 hours plus adjunctive antiseptic (chlorhexidine) treatments (rinsing, pocket irrigation, tongue/tonsil brushing)

Change in bleeding on probing (BOP) · Adults with a clinical diagnosis of (chronic) periodontitis (1999 classification); studies of aggressive periodontitis, systemic disorders…

It is very uncertain whether full-mouth scaling (FMS): scaling/root planing (subgingival… changes change in bleeding on probing (BOP) compared with full-mouth disinfection (FMD): scaling/root planing (subgingival… (very low certainty).

1 finding from 1 review

Full‐mouth treatment modalities (within 24 hours) for periodontitis in adults 2022 · Cochrane All outcomes
6 to 8 months (SoF); similar at 3 to 4 months
MD -0.20 [-13.27, 12.87]
2 studies · 42 participants
Very low

Amoxicillin + metronidazole + SRP vs Supragingival scaling (plus placebo)

CRP (mg/dL) at end of study · People with periodontitis and metabolic syndrome (no CVD; primary prevention)

1 finding from 1 review

Periodontal therapy for primary or secondary prevention of cardiovascular disease in people with periodontitis 2022 · Cochrane All outcomes
12 months
beta coefficient -0.002 [-0.19, 0.20]
1 study
Very low

Full-mouth scaling (FMS): scaling/root planing (subgingival instrumentation) of all quadrants within 24 hours, without antiseptic vs Full-mouth disinfection (FMD): scaling/root planing (subgingival instrumentation) of all quadrants within 24 hours plus adjunctive antiseptic (chlorhexidine) treatments (rinsing, pocket irrigation, tongue/tonsil brushing)

Tooth loss · Adults with a clinical diagnosis of (chronic) periodontitis (1999 classification); studies of aggressive periodontitis, systemic disorders…

The review found no eligible studies for this question.

1 finding from 1 review

Full‐mouth treatment modalities (within 24 hours) for periodontitis in adults 2022 · Cochrane All outcomes
Tooth loss: None of the studies comparing FMS vs FMD reported tooth loss.
0 studies
No studies found

Periodontal treatment (subgingival instrumentation, with or without antimicrobials/surgery) vs usual care or no treatment

Resource implications (e.g. cost of incontinence management methods) · People with diabetes mellitus (type 1 or type 2, mostly type 2) and periodontitis, at least 16 years of age

The review found no eligible studies for this question.

1 finding from 1 review

Treatment of periodontitis for glycaemic control in people with diabetes mellitus 2022 · Cochrane All outcomes
3-4 months
Included studies did not report cost data. A brief economic commentary drew on four external economic evaluations (Smits 2020, Nasseh 2017, Choi 2020, Soloweij-Wedderburn 2017) suggesting potential cost…
0 studies
No studies found

Periodontal treatment (subgingival instrumentation, with or without antimicrobials/surgery) vs usual care or no treatment

Clinical attachment level (CAL) · People with diabetes mellitus (type 1 or type 2, mostly type 2) and periodontitis, at least 16 years of age

Periodontal treatment (subgingival instrumentation, with or without… led to lower clinical attachment level (CAL) compared with no active intervention/usual care; GRADE not reported.

1 finding from 1 review

Treatment of periodontitis for glycaemic control in people with diabetes mellitus 2022 · Cochrane All outcomes
3-4 months
MD -0.48 [-0.65, -0.31]
18 studies
GRADE not reported

Amoxicillin + metronidazole + SRP vs Supragingival scaling (plus placebo)

Fibrinogen · People with periodontitis and metabolic syndrome (no CVD; primary prevention)

1 finding from 1 review

Periodontal therapy for primary or secondary prevention of cardiovascular disease in people with periodontitis 2022 · Cochrane All outcomes
12 months
beta coefficient 10.9 [-12.0, 33.8]
1 study
Very low

Full-mouth scaling (FMS): scaling/root planing (subgingival instrumentation) of all quadrants within 24 hours, without antiseptic vs Quadrant scaling and root planing (control): SRP of each quadrant in separate sessions at least one week apart

Tooth loss · Adults with a clinical diagnosis of (chronic) periodontitis (1999 classification); studies of aggressive periodontitis, systemic disorders…

The review found no eligible studies for this question.

1 finding from 1 review

Full‐mouth treatment modalities (within 24 hours) for periodontitis in adults 2022 · Cochrane All outcomes
Tooth loss: None of the studies comparing FMS vs control reported tooth loss.
0 studies
No studies found

Full-mouth scaling (FMS): scaling/root planing (subgingival instrumentation) of all quadrants within 24 hours, without antiseptic vs Quadrant scaling and root planing (control): SRP of each quadrant in separate sessions at least one week apart

Pocket closure (sites with PPD <=4 mm) · Adults with a clinical diagnosis of (chronic) periodontitis (1999 classification); studies of aggressive periodontitis, systemic disorders…

1 finding from 1 review

Full‐mouth treatment modalities (within 24 hours) for periodontitis in adults 2022 · Cochrane All outcomes
Pocket closure (sites with PPD <=4 mm after treatment): 9 studies reported; all showed increased closed pockets after treatment; 8 of 9 found no between-group difference; Koshy 2005 found a greater change in both…
9 studies
GRADE not reported

Intensive periodontal treatment (subgingival SRP with or without other periodontal treatment) vs Supra-gingival scaling

Diastolic blood pressure (mmHg), change from baseline · Adults (any age/sex) with chronic periodontitis (>=5 teeth remaining; PPD >4 mm), with or without hypertension

Intensive periodontal treatment (subgingival SRP with or without… probably leads to lower change in diastolic blood pressure (DBP, mmHg) compared with supra-gingival scaling (moderate certainty).

3 findings from 1 review

Effect of periodontal treatments on blood pressure 2021 · Cochrane All outcomes
Short term (follow-up 2 months) · People diagnosed with periodontitis and hypertension
MD -8.40 [-12.19, -4.61]
1 study · 101 participants
Moderate
Effect of periodontal treatments on blood pressure 2021 · Cochrane All outcomes
Short term (follow-up 2-3 months) · People diagnosed with periodontitis
MD -2.08 [-4.84, 0.68]
2 studies · 227 participants
Low
Effect of periodontal treatments on blood pressure 2021 · Cochrane All outcomes
Long term (follow-up 6 months) · People diagnosed with periodontitis
MD -4.96 [-13.04, 3.13]
2 studies · 227 participants
Very low

Intensive periodontal treatment (subgingival SRP with or without other periodontal treatment) vs No treatment (no periodontal treatment)

Diastolic blood pressure (mmHg), change from baseline · Adults (any age/sex) with chronic periodontitis (>=5 teeth remaining; PPD >4 mm), with or without hypertension

Periodontal treatment (subgingival SRP with or without other… showed no clear difference in change in diastolic blood pressure (DBP, mmHg) compared with no treatment (no periodontal treatment) (low certainty).

4 findings from 1 review

Effect of periodontal treatments on blood pressure 2021 · Cochrane All outcomes
Long term (follow-up 12 months) · People diagnosed with periodontitis
MD -0.2 [-3.02, 2.62]
1 study · 168 participants
Low
Effect of periodontal treatments on blood pressure 2021 · Cochrane All outcomes
Short term (follow-up 2-3 months) · People diagnosed with periodontitis
MD -0.15 [-2.47, 2.17]
2 studies · 294 participants
Low
Effect of periodontal treatments on blood pressure 2021 · Cochrane All outcomes
Short term (follow-up 3 months) · People diagnosed with periodontitis and other cardiovascular diseases except hypertension
MD -2.45 [-7.95, 3.05]
1 study · 55 participants
Very low

Show 1 more finding

Effect of periodontal treatments on blood pressure 2021 · Cochrane All outcomes
Long term (follow-up 6 months) · People diagnosed with periodontitis and other cardiovascular diseases except hypertension
MD -2.55 [-6.9, 1.8]
2 studies · 103 participants
Low