What do systematic reviews say?

Amoxicillin + clavulanate + SRP vs Tetracycline + SRP

Amoxicillin + clavulanate + SRP showed no clear difference in probing pocket depth compared with tetracycline + 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 -0.40 [-1.11, 0.31]
  1 study · 8 participants
  GRADE not reported

Clindamycin + SRP vs Doxycycline + SRP

The review found no eligible studies for this question.

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

  Long-term (≥ 1 year)
  Included studies have not reported this outcome
  Studies not reported
  No studies found

Cefixime + SRP vs SRP

Cefixime + SRP showed no clear difference in probing pocket depth 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 -0.02 [-0.11, 0.07]
  1 study · 60 participants
  GRADE not reported

Doxycycline + SRP vs Amoxicillin + metronidazole + SRP

Doxycycline + SRP showed no clear difference in adverse events compared with amoxicillin + metronidazole + SRP; GRADE not reported.

• Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes
  One trial (Akincibay 2008) did not report this outcome; Xajigeorgiou 2006 reported mild gastrointestinal discomfort in 2 subjects from the AMOX + MTZ + SRP group.
  1 study
  GRADE not reported

Tetracycline + SRP vs SRP

The review found no eligible studies for this question.

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

  Long-term (≥ 1 year)
  Included studies have not reported this outcome
  Studies not reported
  No studies found
• Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes

  Short-term (≤ 3 months)
  MD -14.62 [-27.21, -2.03]
  1 study · 38 participants
  GRADE not reported

Clindamycin + SRP vs Metronidazole + SRP

The review found no eligible studies for this question.

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

  Long-term (≥ 1 year)
  Included studies have not reported this outcome
  Studies not reported
  No studies found

Tetracycline + SRP vs SRP

The review found no eligible studies for this question.

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

  Long-term (≥ 1 year)
  Included studies have not reported this outcome
  Studies not reported
  No studies found

Rubber/elastomeric cleaning stick plus toothbrushing vs Toothbrushing alone

It is very uncertain whether rubber/elastomeric cleaning stick plus toothbrushing changes gingivitis (proportion of bleeding sites) compared with toothbrushing alone (very low certainty).

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes

  1 month
  MD -0.07 [-0.15, 0.01]
  1 study · 30 participants
  Very low
• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes

  1 month
  MD -0.01 [-0.19, 0.21]
  1 study · 12 participants
  Very low

Rubber/elastomeric cleaning stick plus toothbrushing vs Flossing plus toothbrushing

It is very uncertain whether rubber/elastomeric cleaning stick plus toothbrushing changes plaque compared with flossing plus toothbrushing (very low certainty).

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes

  4 to 6 weeks
  SMD -0.08 [-0.46, 0.29]
  6 studies · 273 participants
  Very low

Flossing plus toothbrushing vs Toothbrushing alone

The review found no eligible studies for this question.

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes
  No included study assessed caries as an outcome.
  0 studies
  No studies found

Wooden cleaning stick plus toothbrushing vs Flossing plus toothbrushing

The review found no eligible studies for this question.

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes
  No included study assessed periodontitis.
  0 studies
  No studies found

Rubber/elastomeric cleaning stick plus toothbrushing vs Flossing plus toothbrushing

It is very uncertain whether rubber/elastomeric cleaning stick plus toothbrushing changes gingivitis (gingival index) compared with flossing plus toothbrushing (very low certainty).

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes

  4 to 6 weeks
  SMD -0.22 [-0.69, 0.24]
  6 studies · 256 participants
  Very low
• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes

  1 month
  MD -0.03 [-0.08, 0.03]
  5 studies · 212 participants
  Low

Wooden cleaning stick plus toothbrushing vs Toothbrushing alone

The review found no eligible studies for this question.

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes
  Gingivitis measured by gingival index: Not measured.
  0 studies
  No studies found
• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes

  3 months
  MD -0.25 [-0.37, -0.13]
  1 study · 24 participants
  Very low

Interdental brushing plus toothbrushing vs Toothbrushing alone

It is very uncertain whether interdental brushing plus toothbrushing changes gingivitis (gingival index) compared with toothbrushing alone (very low certainty).

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes

  1 month
  MD -0.53 [-0.83, -0.23]
  1 study · 62 participants
  Very low
• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes

  1 month
  MD -0.05 [-0.13, 0.03]
  1 study · 31 participants
  Very low
• Interdental brushing for the prevention and control of periodontal diseases and dental caries in adults 2013 · Cochrane All outcomes

  4 weeks (1 month)
  MD -0.53 [-0.83, -0.23]
  1 study · 62 participants
  Very low

Oral irrigation plus toothbrushing vs Flossing plus toothbrushing

The review found no eligible studies for this question.

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes
  No included study assessed periodontitis.
  0 studies
  No studies found

Oral irrigation plus toothbrushing vs Flossing plus toothbrushing

It is very uncertain whether oral irrigation plus toothbrushing changes gingivitis (gingival index) compared with flossing plus toothbrushing (very low certainty).

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes

  1 month
  MD -0.06 [-0.12, 0.00]
  1 study · 63 participants
  Very low
• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes

  1 month
  MD -0.12 [-0.19, -0.05]
  2 studies · 133 participants
  Low

Interdental brushing plus toothbrushing vs Toothbrushing alone

Interdental brushing plus toothbrushing may leads to lower plaque compared with toothbrushing alone (low certainty).

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes

  1 month
  SMD -1.07 [-1.51, -0.63]
  2 studies · 93 participants
  Low
• Interdental brushing for the prevention and control of periodontal diseases and dental caries in adults 2013 · Cochrane All outcomes

  4 weeks (1 month)
  MD -0.95 [-1.34, -0.56]
  1 study · 62 participants
  Very low

Wooden cleaning stick plus toothbrushing vs Toothbrushing alone

It is very uncertain whether wooden cleaning stick plus toothbrushing changes plaque compared with toothbrushing alone (very low certainty).

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes

  3 months
  MD -0.03 [-0.13, 0.07]
  1 study · 24 participants
  Very low

Oral irrigation plus toothbrushing vs Toothbrushing alone

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes
  Periodontitis measured in one study but useable data not provided (Walsh 1989 reported proportion of sites with >4 mm pocket depth at 3 months but not mean PD; attachment loss measured but no data).
  1 study
  GRADE not reported

Oral irrigation plus toothbrushing vs Toothbrushing alone

It is very uncertain whether oral irrigation plus toothbrushing changes gingivitis (gingival index) compared with toothbrushing alone (very low certainty).

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes

  1 month
  SMD -0.48 [-0.89, -0.06]
  4 studies · 380 participants
  Very low
• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes

  1 month
  MD -0.00 [-0.07, 0.06]
  2 studies · 126 participants
  Low