What do systematic reviews say?

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

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

Periodontal treatment (scaling and root planing, alone or with antimicrobials) vs Alternative (less intensive) periodontal treatment, alone or with placebo

Periodontal treatment (scaling and root planing, alone or with… led to lower clinical attachment level compared with alternative (less intensive) periodontal treatment, alone or with…; GRADE not reported.

• Treating periodontal disease for preventing adverse birth outcomes in pregnant women 2017 · Cochrane All outcomes
  MD -0.13 [-0.23, -0.03]
  1 study · 53 participants
  GRADE not reported

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

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

• 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

Mechanical debridement plus local antimicrobial (minocycline microspheres or doxycycline gel) vs Mechanical debridement alone

Mechanical debridement plus local antimicrobial (minocycline… showed no clear difference in clinical attachment level (mm) compared with mechanical debridement alone (low certainty).

• Supportive periodontal therapy (SPT) for maintaining the dentition in adults treated for periodontitis 2018 · Cochrane All outcomes

  12 months
  MD 0.10 [-0.42, 0.62]
  1 study · 53 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

Doxycycline + SRP vs Metronidazole + SRP

Doxycycline + SRP showed no clear difference in clinical attachment level (CAL) compared with metronidazole + SRP; 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 0.34 [-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

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

• 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

Amoxicillin + metronidazole + SRP showed no clear difference in clinical attachment level (CAL) compared with clarithromycin + SRP; 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 0.00 [-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

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

• 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

Tetracycline + SRP led to lower clinical attachment level (CAL) compared with SRP; 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 -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

Clindamycin + SRP led to lower clinical attachment level (CAL) compared with SRP; 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 -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

Doxycycline + SRP showed no clear difference in clinical attachment level (CAL) compared with amoxicillin + metronidazole + SRP; 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 0.17 [-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

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

• 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

Metronidazole + SRP showed no clear difference in clinical attachment level (CAL) compared with amoxicillin + metronidazole + SRP; 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 0.06 [-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

Cefixime + SRP vs SRP

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

• Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes

  Short-term (≤ 3 months)
  MD -0.19 [-0.77, 0.39]
  1 study · 60 participants
  GRADE not reported

Amoxicillin + clavulanate + SRP vs SRP

Amoxicillin + clavulanate + SRP showed no clear difference in clinical attachment level (CAL) compared with SRP; 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 0.10 [-0.45, 0.65]
  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 0.10 [-0.51, 0.71]
  1 study · 21 participants
  Very low
• Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes

  Short-term (≤ 3 months)
  MD 0.10 [-0.43, 0.63]
  1 study · 21 participants
  GRADE not reported

Clindamycin + SRP vs Metronidazole + SRP

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

• Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes

  Short-term (≤ 3 months)
  MD 0.40 [-0.22, 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

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

• 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