Findings

What do systematic reviews say?

18 questions · 40 findings · 3 reviews · All outcomes

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No studies found 0 · 0%GRADE not reported 28 · 70%Very low 9 · 22.5%Low 3 · 7.5%Moderate 0 · 0%High 0 · 0%

Doxycycline + SRP vs Metronidazole + SRP

Clinical attachment level (CAL) · Adults with aggressive periodontitis

Doxycycline + SRP showed no clear difference in clinical attachment level (CAL) compared with metronidazole + SRP; GRADE not reported.

3 findings from 1 review

Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
Intermediate-term (> 3 months to < 1 year)
MD 0.34 [-0.08, 0.76]
3 studies · 75 participants
GRADE not reported
Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
Long-term (≥ 1 year)
MD 1.10 [0.36, 1.84]
1 study · 27 participants
Very low
Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
Short-term (≤ 3 months)
MD -0.12 [-0.72, 0.49]
2 studies · 49 participants
GRADE not reported

Doxycycline + SRP vs SRP

Clinical attachment level (CAL) · Adults with aggressive periodontitis

It is very uncertain whether doxycycline + SRP changes clinical attachment level (CAL) compared with SRP (very low certainty).

3 findings from 1 review

Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
Long-term (≥ 1 year)
MD -0.80 [-1.49, -0.11]
1 study · 22 participants
Very low
Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
Intermediate-term (> 3 months to < 1 year)
MD -0.61 [-1.14, -0.08]
3 studies · 65 participants
GRADE not reported
Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
Short-term (≤ 3 months)
MD 0.15 [-0.53, 0.83]
2 studies · 43 participants
GRADE not reported

Amoxicillin + metronidazole + SRP vs Clarithromycin + SRP

Clinical attachment level (CAL) · Adults with aggressive periodontitis

Amoxicillin + metronidazole + SRP showed no clear difference in clinical attachment level (CAL) compared with clarithromycin + SRP; GRADE not reported.

2 findings from 1 review

Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
Intermediate-term (> 3 months to < 1 year)
MD 0.00 [-0.26, 0.26]
1 study · 46 participants
GRADE not reported
Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
Short-term (≤ 3 months)
MD -0.60 [-0.86, -0.34]
1 study · 46 participants
GRADE not reported

Clindamycin + SRP vs Doxycycline + SRP

Clinical attachment level (CAL) · Adults with aggressive periodontitis

It is very uncertain whether clindamycin + SRP changes clinical attachment level (CAL) compared with doxycycline + SRP (very low certainty).

3 findings from 1 review

Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
Long-term (≥ 1 year)
MD -0.90 [-1.62, -0.18]
1 study · 23 participants
Very low
Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
Intermediate-term (> 3 months to < 1 year)
MD -0.40 [-1.15, 0.35]
1 study · 23 participants
GRADE not reported
Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
Short-term (≤ 3 months)
MD 0.50 [-0.26, 1.26]
1 study · 23 participants
GRADE not reported

Tetracycline + SRP vs SRP

Clinical attachment level (CAL) · Adults with aggressive periodontitis

Tetracycline + SRP led to lower clinical attachment level (CAL) compared with SRP; GRADE not reported.

3 findings from 1 review

Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
Intermediate-term (> 3 months to < 1 year)
MD -1.90 [-2.17, -1.63]
1 study · 26 participants
GRADE not reported
Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
Long-term (≥ 1 year)
MD -2.30 [-2.50, -2.10]
1 study · 26 participants
Very low
Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
Short-term (≤ 3 months)
MD -0.92 [-2.38, 0.54]
2 studies · 64 participants
GRADE not reported

Clindamycin + SRP vs SRP

Clinical attachment level (CAL) · Adults with aggressive periodontitis

Clindamycin + SRP led to lower clinical attachment level (CAL) compared with SRP; GRADE not reported.

3 findings from 1 review

Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
Intermediate-term (> 3 months to < 1 year)
MD -1.30 [-2.14, -0.46]
1 study · 21 participants
GRADE not reported
Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
Short-term (≤ 3 months)
MD 0.40 [-0.35, 1.15]
1 study · 21 participants
GRADE not reported
Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
Long-term (≥ 1 year)
MD -1.70 [-2.40, -1.00]
1 study · 21 participants
Very low

Doxycycline + SRP vs Amoxicillin + metronidazole + SRP

Clinical attachment level (CAL) · Adults with aggressive periodontitis

Doxycycline + SRP showed no clear difference in clinical attachment level (CAL) compared with amoxicillin + metronidazole + SRP; GRADE not reported.

2 findings from 1 review

Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
Intermediate-term (> 3 months to < 1 year)
MD 0.17 [-1.28, 1.62]
1 study · 20 participants
GRADE not reported
Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
Short-term (≤ 3 months)
MD 0.20 [0.06, 0.33]
2 studies · 50 participants
GRADE not reported

Clarithromycin + SRP vs SRP

Clinical attachment level (CAL) · Adults with periodontitis (chronic and aggressive)

Clarithromycin + SRP led to lower clinical attachment level (CAL) compared with SRP; GRADE not reported.

2 findings from 1 review

Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
Short-term (≤ 3 months)
MD -0.65 [-1.20, -0.09]
2 studies · 77 participants
GRADE not reported
Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
Intermediate-term (> 3 months to < 1 year)
MD -0.64 [-1.26, -0.03]
2 studies · 77 participants
GRADE not reported

Metronidazole + SRP vs Amoxicillin + metronidazole + SRP

Clinical attachment level (CAL) · Adults with periodontitis (chronic and aggressive)

Metronidazole + SRP showed no clear difference in clinical attachment level (CAL) compared with amoxicillin + metronidazole + SRP; GRADE not reported.

2 findings from 1 review

Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
Intermediate-term (> 3 months to < 1 year)
MD 0.06 [-1.06, 1.18]
1 study · 22 participants
GRADE not reported
Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
Short-term (≤ 3 months)
MD -0.07 [-0.40, 0.26]
3 studies · 84 participants
GRADE not reported

Clindamycin + SRP vs Metronidazole + SRP

Clinical attachment level (CAL) · Adults with aggressive periodontitis

Clindamycin + SRP showed no clear difference in clinical attachment level (CAL) compared with metronidazole + SRP; GRADE not reported.

3 findings from 1 review

Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
Short-term (≤ 3 months)
MD 0.40 [-0.22, 1.02]
1 study · 26 participants
GRADE not reported
Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
Long-term (≥ 1 year)
MD 0.20 [-0.55, 0.95]
1 study · 26 participants
Very low
Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
Intermediate-term (> 3 months to < 1 year)
MD 0.10 [-0.60, 0.80]
1 study · 26 participants
GRADE not reported

Amoxicillin + metronidazole + SRP vs SRP

Clinical attachment level (CAL) · Adults with periodontitis (chronic and aggressive)

It is very uncertain whether amoxicillin + metronidazole + SRP changes clinical attachment level (CAL) compared with SRP (very low certainty).

3 findings from 1 review

Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
Long-term (≥ 1 year)
MD -0.47 [-0.90, -0.05]
2 studies · 389 participants
Very low
Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
Short-term (≤ 3 months)
MD -0.21 [-0.41, -0.01]
13 studies · 501 participants
GRADE not reported
Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
Intermediate-term (> 3 months to < 1 year)
MD -0.04 [-0.35, 0.26]
6 studies · 215 participants
GRADE not reported

Azithromycin + SRP vs SRP

Clinical attachment level (CAL) · Adults with periodontitis (chronic and aggressive)

It is very uncertain whether azithromycin + SRP changes clinical attachment level (CAL) compared with SRP (very low certainty).

3 findings from 1 review

Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
Long-term (≥ 1 year)
MD -0.59 [-1.27, 0.08]
2 studies · 110 participants
Very low
Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
Intermediate-term (> 3 months to < 1 year)
MD -0.43 [-0.77, -0.10]
7 studies · 258 participants
GRADE not reported
Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
Short-term (≤ 3 months)
MD -0.51 [-0.83, -0.19]
6 studies · 216 participants
GRADE not reported

Metronidazole + SRP vs SRP

Clinical attachment level (CAL) · Adults with periodontitis (chronic and aggressive)

Metronidazole + SRP showed no clear difference in clinical attachment level (CAL) compared with SRP; GRADE not reported.

3 findings from 1 review

Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
Short-term (≤ 3 months)
MD 0.04 [-0.43, 0.50]
4 studies · 108 participants
GRADE not reported
Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
Long-term (≥ 1 year)
MD -1.12 [-2.24, 0.00]
3 studies · 71 participants
Very low
Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
Intermediate-term (> 3 months to < 1 year)
MD -0.49 [-1.29, 0.31]
4 studies · 94 participants
GRADE not reported

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

Attachment change · 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 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 0.10 [-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)

Attachment change · 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 clinical attachment level (CAL) 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); 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

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

Guided tissue regeneration (GTR) with barrier membrane (resorbable or non-resorbable) vs Open flap debridement (access flap surgery)

Attachment change · Patients with chronic periodontitis (aged 21 years or older) with periodontal infra-bony defects; furcation-involved teeth and aggressive…

Guided tissue regeneration (GTR) with barrier membrane (resorbable… led to higher change in clinical attachment level (attachment gain) compared with open flap debridement (access flap surgery); GRADE not reported.

1 finding from 1 review

Guided tissue regeneration for periodontal infra-bony defects 2006 · Cochrane All outcomes
>=12 months
MD 1.22 [0.80, 1.64]
16 studies
GRADE not reported

GTR rm associated with bone substitutes vs Open flap debridement (access flap surgery)

Attachment change · Patients with chronic periodontitis (aged 21 years or older) with periodontal infra-bony defects; furcation-involved teeth and aggressive…

Guided tissue regeneration (GTR) combined with bone substitutes/graft led to higher change in clinical attachment level (attachment gain) compared with open flap debridement (access flap surgery); GRADE not reported.

1 finding from 1 review

Guided tissue regeneration for periodontal infra-bony defects 2006 · Cochrane All outcomes
>=12 months
MD 1.25 [0.89, 1.61]
2 studies
GRADE not reported