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 probing pocket depth (PPD) 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 0.44 [0.29, 0.59]
  35 studies · 873 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 0.52 [0.31, 0.74]
  15 studies · 452 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

Adjunctive antimicrobial photodynamic therapy (aPDT) applied after… showed no clear difference in change in probing pocket depth (PPD) 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 0.44 [-0.20, 1.08]
  6 studies · 244 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 -0.04 [-0.19, 0.10]
  3 studies · 125 participants
  Very 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 probing pocket depth (PPD) 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 0.11 [-0.04, 0.27]
  6 studies · 214 participants
  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

Full-mouth scaling (FMS): scaling/root planing (subgingival… showed no clear difference in change in probing pocket depth (PPD) 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 0.03 [-0.14, 0.20]
  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 probing pocket depth (PPD) 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); similar at 3 to 4 months
  MD -0.11 [-0.30, 0.07]
  4 studies · 112 participants
  Low

Nanocrystalline hydroxyapatite (Ostim) vs Bovine-derived xenograft (Bio-Oss) plus resorbable barrier

Nanocrystalline hydroxyapatite (Ostim) led to lower change in probing pocket depth (PPD) compared with bovine-derived xenograft (Bio-Oss) plus resorbable barrier; GRADE not reported.

• Interventions for replacing missing teeth: treatment of peri‐implantitis 2012 · Cochrane All outcomes

  4 years
  MD -1.4 [-1.99, -0.81]
  1 study · 22 participants
  GRADE not reported

Er:YAG laser debridement vs Manual debridement plus chlorhexidine irrigation/gel

Er:YAG laser debridement showed no clear difference in change in probing pocket depth (PPD) compared with manual debridement plus chlorhexidine irrigation/gel; GRADE not reported.

• Interventions for replacing missing teeth: treatment of peri‐implantitis 2012 · Cochrane All outcomes

  6 months
  No statistically significant differences for change in PPD.
  1 study · 20 participants
  GRADE not reported

Adjunctive local antibiotic (8.5% doxycycline hyclate, Atridox) added to manual debridement vs Manual debridement plus chlorhexidine irrigation/gel

Adjunctive local antibiotic (8.5% doxycycline hyclate, Atridox)… led to higher change in probing pocket depth (PPD) compared with manual debridement with chlorhexidine (no antibiotic); GRADE not reported.

• Interventions for replacing missing teeth: treatment of peri‐implantitis 2012 · Cochrane All outcomes

  4 months (18 weeks)
  MD 0.59 [0.39, 0.79]
  1 study · 28 participants
  GRADE not reported

Enamel matrix derivative (EMD; Emdogain) vs Guided tissue regeneration (GTR) with barriers

Enamel matrix derivative (EMD; Emdogain) showed no clear difference in change in probing pocket depth (PPD) compared with guided tissue regeneration (GTR) with barriers (low certainty).

• Enamel matrix derivative (Emdogain®) for periodontal tissue regeneration in intrabony defects 2009 · Cochrane All outcomes

  1 year (time-points 1, 5 and 10 years planned)
  MD -0.4 [-1.1, 0.2]
  6 studies · 304 participants
  Low

Enamel matrix derivative (EMD; Emdogain) vs placebo or control

Enamel matrix derivative (EMD; Emdogain) may leads to higher change in probing pocket depth (PPD) compared with placebo or control (same surgical or non-surgical intervention… (low certainty).

• Enamel matrix derivative (Emdogain®) for periodontal tissue regeneration in intrabony defects 2009 · Cochrane All outcomes

  1 year (time-points 1, 5 and 10 years planned)
  MD 0.88 [0.44, 1.31]
  9 studies · 371 participants
  Low

Enamel matrix derivative (EMD; Emdogain) vs Various bone grafting (BG) procedures (animal-derived or synthetic bone / bioactive ceramic filler)

• Enamel matrix derivative (Emdogain®) for periodontal tissue regeneration in intrabony defects 2009 · Cochrane All outcomes

  1 year (time-points 1, 5 and 10 years planned)
  No statistically significant differences (one trial, Leknes 2009).
  1 study
  GRADE not reported

Er:YAG laser surface debridement before bone augmentation vs Plastic curettes plus saline solution before bone augmentation

Er:YAG laser surface debridement before bone augmentation showed no clear difference in change in probing pocket depth (PPD reduction) compared with plastic curettes plus saline solution before bone augmentation; GRADE not reported.

• Interventions for replacing missing teeth: treatment of peri‐implantitis 2012 · Cochrane All outcomes

  6 months
  Six months after treatment there were no statistically significant differences for PPD reduction.
  1 study · 30 participants
  GRADE not reported