What do systematic reviews say?

Adjunctive antimicrobial photodynamic therapy (aPDT) applied after subgingival instrumentation (SI) vs Subgingival instrumentation (SI) alone (hand or power-driven, or both), or SI plus placebo/sham aPDT

Adjunctive antimicrobial photodynamic therapy (aPDT) applied after… led to higher change in clinical attachment level (CAL) compared with subgingival instrumentation (SI) alone (hand or power-driven, or…; GRADE not reported.

• Adjunctive antimicrobial photodynamic therapy for treating periodontal and peri‐implant diseases 2024 · Cochrane All outcomes

  3 months (change from baseline)
  MD 0.36 [0.24, 0.48]
  34 studies · 875 participants
  GRADE not reported
• Adjunctive antimicrobial photodynamic therapy for treating periodontal and peri‐implant diseases 2024 · Cochrane All outcomes

  6 months (change from baseline)
  MD 0.44 [0.24, 0.64]
  13 studies · 414 participants
  Very low

Adjunctive antimicrobial photodynamic therapy (aPDT) applied after subgingival instrumentation (SI) vs Subgingival instrumentation (SI) alone (hand or power-driven, or both), or SI plus placebo/sham aPDT

It is very uncertain whether adjunctive antimicrobial photodynamic therapy (aPDT) applied after… changes change in clinical attachment level (CAL) compared with subgingival instrumentation (SI) alone (hand or power-driven, or… (very low certainty).

• Adjunctive antimicrobial photodynamic therapy for treating periodontal and peri‐implant diseases 2024 · Cochrane All outcomes

  6 months (change from baseline)
  MD 0.07 [-0.26, 0.40]
  2 studies · 85 participants
  Very low
• Adjunctive antimicrobial photodynamic therapy for treating periodontal and peri‐implant diseases 2024 · Cochrane All outcomes

  3 months (change from baseline)
  MD 0.07 [-0.21, 0.36]
  5 studies · 204 participants
  GRADE not reported

Adjunctive antimicrobial photodynamic therapy (aPDT) applied after submucosal instrumentation (SI) vs Submucosal instrumentation (SI) alone, or SI plus placebo/sham aPDT

The review found no eligible studies for this question.

• Adjunctive antimicrobial photodynamic therapy for treating periodontal and peri‐implant diseases 2024 · Cochrane All outcomes
  Only one study reported evidence for adjunctive aPDT in people with peri-implant disease (Al Rifaiy 2022). Data were only available for two outcomes (PPD and BOP), both reported only at three months. No studies…
  Studies not reported
  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

Full-mouth scaling (FMS): 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).

• 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 0.10 [-0.05, 0.26]
  5 studies · 148 participants
  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)

Full-mouth scaling (FMS): scaling/root planing (subgingival… showed no clear difference in change in clinical attachment level (CAL) compared with full-mouth disinfection (FMD): scaling/root planing (subgingival… (low certainty).

• Full‐mouth treatment modalities (within 24 hours) for periodontitis in adults 2022 · Cochrane All outcomes

  6 to 8 months (SoF); 3 to 4 months favoured FMD
  MD -0.05 [-0.23, 0.13]
  4 studies · 112 participants
  Low

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

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).

• 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

GTR rm + CAF vs GTR nrm + CAF

GTR rm + CAF showed no clear difference in clinical attachment level change compared with GTR nrm + CAF; GRADE not reported.

• Root coverage procedures for treating localised and multiple recession‐type defects 2018 · Cochrane All outcomes

  Short term (6 to 12 months)
  MD 0.12 [-0.37, 0.60]
  2 studies
  GRADE not reported

Autologous platelet concentrates (APC) + guided tissue regeneration (GTR) vs GTR (guided tissue regeneration) alone

It is very uncertain whether autologous platelet concentrates (APC) + guided tissue regeneration… changes change in clinical attachment level (CAL) (mm) compared with GTR (guided tissue regeneration) alone (very low certainty).

• Autologous platelet concentrates for treating periodontal infrabony defects 2018 · Cochrane All outcomes

  All follow-ups
  MD 0.42 [-0.02, 0.86]
  7 studies · 248 participants
  Very low
• Autologous platelet concentrates for treating periodontal infrabony defects 2018 · Cochrane All outcomes

  9 to 12 months
  MD 0.27 [-0.39, 0.93]
  5 studies · 164 participants
  GRADE not reported
• Autologous platelet concentrates for treating periodontal infrabony defects 2018 · Cochrane All outcomes

  3 to 6 months · Split-mouth studies only
  MD 0.54 [0.18, 0.89]
  3 studies · 134 participants
  GRADE not reported

Autologous platelet concentrates (APC) + enamel matrix derivative (EMD) vs EMD (enamel matrix derivative) alone

It is very uncertain whether autologous platelet concentrates (APC) + enamel matrix derivative… changes change in clinical attachment level (CAL) (mm) compared with EMD (enamel matrix derivative) alone (very low certainty).

• Autologous platelet concentrates for treating periodontal infrabony defects 2018 · Cochrane All outcomes

  All follow-ups
  MD 0.10 [-0.13, 0.32]
  2 studies · 75 participants
  Very low

Autologous platelet concentrates (APC) + open flap debridement (OFD) + bone graft (BG) vs OFD + BG (open flap debridement + bone graft)

It is very uncertain whether autologous platelet concentrates (APC) + open flap debridement (OFD)… changes change in clinical attachment level (CAL) (mm) compared with OFD + BG (open flap debridement + bone graft) (very low certainty).

• Autologous platelet concentrates for treating periodontal infrabony defects 2018 · Cochrane All outcomes

  All follow-ups
  MD 0.72 [0.43, 1.00]
  17 studies · 569 participants
  Very low
• Autologous platelet concentrates for treating periodontal infrabony defects 2018 · Cochrane All outcomes

  3 to 6 months
  MD 0.47 [0.11, 0.84]
  11 studies · 272 participants
  GRADE not reported
• Autologous platelet concentrates for treating periodontal infrabony defects 2018 · Cochrane All outcomes

  9 to 12 months · Split-mouth studies only
  MD 0.84 [0.62, 1.06]
  6 studies · 192 participants
  GRADE not reported

GTR rm + CAF vs SCTG + CAF

GTR rm + CAF may leads to higher clinical attachment level change compared with SCTG + CAF (low certainty).

• Root coverage procedures for treating localised and multiple recession‐type defects 2018 · Cochrane All outcomes

  Short term (6 to 12 months)
  MD 0.35 [0.06, 0.63]
  3 studies · 98 participants
  Low

GTR rm associated with bone substitutes + CAF vs SCTG + CAF

GTR rm associated with bone substitutes + CAF showed no clear difference in clinical attachment level change compared with SCTG + CAF; GRADE not reported.

• Root coverage procedures for treating localised and multiple recession‐type defects 2018 · Cochrane All outcomes

  Short term (6 to 12 months)
  MD -0.52 [-1.34, 0.30]
  2 studies
  GRADE not reported

ADMG + CAF vs CAF

ADMG + CAF showed no clear difference in clinical attachment level change compared with CAF (low certainty).

• Root coverage procedures for treating localised and multiple recession‐type defects 2018 · Cochrane All outcomes

  Short term (6 to 12 months)
  MD 0.51 [-0.25, 1.27]
  2 studies · 50 participants
  Low

GTR rm associated with bone substitutes + CAF vs GTR rm + CAF

GTR rm associated with bone substitutes + CAF showed no clear difference in clinical attachment level change compared with GTR rm + CAF; GRADE not reported.

• Root coverage procedures for treating localised and multiple recession‐type defects 2018 · Cochrane All outcomes

  Short term (6 to 12 months)
  MD 0.76 [-0.01, 1.54]
  2 studies
  GRADE not reported

ADMG + CAF vs SCTG + CAF

ADMG + CAF showed no clear difference in clinical attachment level change compared with SCTG + CAF (low certainty).

• Root coverage procedures for treating localised and multiple recession‐type defects 2018 · Cochrane All outcomes

  Short term (6 to 12 months)
  MD -0.53 [-1.14, 0.08]
  4 studies · 100 participants
  Low

EMP + CAF vs CAF

EMP + CAF showed no clear difference in clinical attachment level change compared with CAF (low certainty).

• Root coverage procedures for treating localised and multiple recession‐type defects 2018 · Cochrane All outcomes

  Short term (6 to 12 months)
  MD 0.22 [-0.02, 0.45]
  3 studies · 136 participants
  Low
• Root coverage procedures for treating localised and multiple recession‐type defects 2018 · Cochrane All outcomes

  Short and medium term (6 to 24 months)
  MD 0.35 [0.09, 0.61]
  3 studies
  GRADE not reported

PRF + CAF vs SCTG + CAF

PRF + CAF led to lower clinical attachment level change compared with SCTG + CAF; GRADE not reported.

• Root coverage procedures for treating localised and multiple recession‐type defects 2018 · Cochrane All outcomes

  Short term (6 to 12 months)
  MD -0.37 [-0.69, -0.06]
  2 studies
  GRADE not reported

Autologous platelet concentrates (APC) + open flap debridement (OFD) vs Open flap debridement (access flap surgery)

It is very uncertain whether autologous platelet concentrates (APC) + open flap debridement (OFD) changes change in clinical attachment level (CAL) (mm) compared with OFD (open flap debridement) alone (very low certainty).

• Autologous platelet concentrates for treating periodontal infrabony defects 2018 · Cochrane All outcomes

  9 to 12 months
  MD 1.47 [1.11, 1.82]
  12 studies · 510 participants
  Very low

XCM + CAF vs CAF

XCM + CAF showed no clear difference in clinical attachment level change compared with CAF (low certainty).

• Root coverage procedures for treating localised and multiple recession‐type defects 2018 · Cochrane All outcomes

  Short term (6 to 12 months)
  MD 0.37 [-0.09, 0.83]
  2 studies · 104 participants
  Low

Periodontal treatment (scaling and root planing, polishing, or surgery), alone or with oral hygiene counselling, antiseptics, or antimicrobials vs no treatment

• Treating periodontal disease for preventing adverse birth outcomes in pregnant women 2017 · Cochrane All outcomes
  Reported as a secondary periodontal outcome (Analysis 1.7); results not meta-analysed due to considerable heterogeneity (I2 91% to 100%); reduction in favour of periodontal treatment.
  4 studies
  GRADE not reported