What do systematic reviews say?

Amoxicillin + metronidazole + SRP vs Supragingival scaling (plus placebo)

It is very uncertain whether scaling and root planing (SRP) plus antibiotics (amoxicillin and… changes adverse events due to periodontal therapy compared with supragingival scaling (plus placebo) (very low certainty).

• Periodontal therapy for primary or secondary prevention of cardiovascular disease in people with periodontitis 2022 · Cochrane All outcomes

  12 months
  Peto OR 0.14 [0.00, 6.90]
  1 study · 165 participants
  Very low

Amoxicillin + metronidazole + SRP vs Supragingival scaling (plus placebo)

It is very uncertain whether scaling and root planing (SRP) plus antibiotics (amoxicillin and… changes all cardiovascular events compared with supragingival scaling (plus placebo) (very low certainty).

• Periodontal therapy for primary or secondary prevention of cardiovascular disease in people with periodontitis 2022 · Cochrane All outcomes

  12 months
  Peto OR 7.77 [1.07, 56.1]
  1 study · 165 participants
  Very low

Amoxicillin + metronidazole + SRP vs Supragingival scaling (plus placebo)

It is very uncertain whether scaling and root planing (SRP) plus antibiotics (amoxicillin and… changes all CVD-related death compared with supragingival scaling (plus placebo) (very low certainty).

• Periodontal therapy for primary or secondary prevention of cardiovascular disease in people with periodontitis 2022 · Cochrane All outcomes

  12 months
  Peto OR 7.48 [0.15, 376.98]
  1 study · 165 participants
  Very low

Amoxicillin + metronidazole + SRP vs Supragingival scaling (plus placebo)

It is very uncertain whether scaling and root planing (SRP) plus antibiotics (amoxicillin and… changes all-cause death compared with supragingival scaling (plus placebo) (very low certainty).

• Periodontal therapy for primary or secondary prevention of cardiovascular disease in people with periodontitis 2022 · Cochrane All outcomes

  12 months
  Peto OR 7.48 [0.15, 376.98]
  1 study · 165 participants
  Very low

Amoxicillin + metronidazole + SRP vs Supragingival scaling (plus placebo)

• Periodontal therapy for primary or secondary prevention of cardiovascular disease in people with periodontitis 2022 · Cochrane All outcomes

  12 months
  beta coefficient -0.002 [-0.19, 0.20]
  1 study
  Very low

Amoxicillin + metronidazole + SRP vs Supragingival scaling (plus placebo)

• Periodontal therapy for primary or secondary prevention of cardiovascular disease in people with periodontitis 2022 · Cochrane All outcomes

  12 months
  beta coefficient 10.9 [-12.0, 33.8]
  1 study
  Very 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 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 treatment modalities (within 24 hours) for periodontitis in adults 2022 · Cochrane All outcomes
  Pocket closure (number/proportion of sites with PPD <=4 mm after treatment): 9 studies reported; all showed an increase in closed pockets after treatment; 8 of 9 found no between-group difference; Koshy 2005 found a…
  9 studies
  GRADE not reported

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 treatment modalities (within 24 hours) for periodontitis in adults 2022 · Cochrane All outcomes
  13 studies provided adverse-event/participant-reported information; 3 reported an event after FMD or FMS; most important harm was increased body temperature. FMD/chlorhexidine-specific harms reported by Fonseca 2015…
  13 studies
  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

• Full‐mouth treatment modalities (within 24 hours) for periodontitis in adults 2022 · Cochrane All outcomes
  13 studies provided adverse-event/participant-reported information; 3 reported an event after FMD or FMS; most important harm was increased body temperature after treatment. Narrative, not separated by comparison and…
  13 studies
  GRADE not reported

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 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

The review found no eligible studies for this question.

• Full‐mouth treatment modalities (within 24 hours) for periodontitis in adults 2022 · Cochrane All outcomes
  Tooth loss: None of the studies comparing FMD vs control reported tooth loss.
  0 studies
  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

It is very uncertain whether full-mouth scaling (FMS): scaling/root planing (subgingival… changes change in bleeding on probing (BOP) compared with quadrant scaling and root planing (control): SRP of each quadrant in… (very 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 2.64 [-8.81, 14.09]
  3 studies · 80 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

It is very uncertain whether full-mouth disinfection (FMD): scaling/root planing (subgingival… changes change in bleeding on probing (BOP) compared with quadrant scaling and root planing (control): SRP of each quadrant in… (very 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 9.54 [-2.24, 21.32]
  4 studies · 92 participants
  Very 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

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

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)

It is very uncertain whether full-mouth scaling (FMS): scaling/root planing (subgingival… changes change in bleeding on probing (BOP) compared with full-mouth disinfection (FMD): scaling/root planing (subgingival… (very 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 -0.20 [-13.27, 12.87]
  2 studies · 42 participants
  Very 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)

The review found no eligible studies for this question.

• Full‐mouth treatment modalities (within 24 hours) for periodontitis in adults 2022 · Cochrane All outcomes
  Tooth loss: None of the studies comparing FMS vs FMD reported tooth loss.
  0 studies
  No studies found