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Each row is one question a systematic review asked: who, what, compared with what, and which outcome, with the effect it found and how certain that is. Words match anywhere in the field.
793 questions in 32 reviews · Periodontology
current versionsNo studies 148 · 18.7%Ungraded 429 · 54.1%Very low 137 · 17.3%Low 53 · 6.7%Moderate 14 · 1.8%High 12 · 1.5%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
| Question | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Periodontitis vs No periodontitis (periodontal health or gingivitis) Dental caries (prevalence) · Adults · Male Association between periodontitis and dental caries: a systematic review and meta-analysis. (2024) | OR 1.48 [1.26, 1.74] | 2 studies | Ungraded |
Periodontitis vs No periodontitis (periodontal health or gingivitis) Dental caries (prevalence) · Adults · Severe periodontitis Association between periodontitis and dental caries: a systematic review and meta-analysis. (2024) | OR 2.14 [1.74, 2.64] | 7 studies | Ungraded |
Intervention NR Decayed, missing, filled surfaces (DMFS) · Periodontal disease severity (CDC-AAP); single study (Robert 2019); adjusted Association between periodontitis and dental caries: a systematic review and meta-analysis. (2024) | OR 1.03 [1.01, 1.05] | 1 study | Ungraded |
Single preoperative dose of systemic antibiotics (clindamycin 600 mg), total chemo-mechanical debridement and root filling vs Matched placebo, total chemo-mechanical debridement and root filling Adverse effects · Adults with symptomatic apical periodontitis (no signs of spreading infection or systemic involvement) · 7 days Systemic antibiotics for symptomatic apical periodontitis and acute apical abscess in adults (2024) · Cochrane | No adverse effects reported in the placebo group; 1 participant reported dizziness in the intervention group. 72 participants (1 study). | 1 study · 72 participants | Low |
Cleft lip and palate vs No cleft lip and palate Streptococcus mutans mean levels/counts · Children and adolescents aged 0 to 18 years with nonsyndromic cleft lip and palate Characterization of the oral microbiota and the relationship of the oral microbiota with the dental and… (2024) | SMD 1.78 [1.36, 2.19] | 2 studies · 175 participants | Ungraded |
Periodontitis vs No periodontitis (periodontal health or gingivitis) Mean DFR (decayed, filled root teeth) · Adults · Overall Association between periodontitis and dental caries: a systematic review and meta-analysis. (2024) | WMD 1.13 [0.48, 1.78] | 4 studies | Ungraded |
Postoperative systemic antibiotics (phenoxymethylpenicillin/penicillin VK, 7-day course), partial or total chemo-mechanical debridement and analgesics vs Matched placebo, partial or total chemo-mechanical debridement and analgesics Number of paracetamol (acetaminophen) with codeine tablets required · Adults with a symptomatic necrotic tooth or localised acute apical abscess (no signs of spreading infection or… · 7 days Systemic antibiotics for symptomatic apical periodontitis and acute apical abscess in adults (2024) · Cochrane | MD -0.31 [-3.94, 3.32] | 1 study · 41 participants | Ungraded |
Adjunctive antimicrobial photodynamic therapy (aPDT) applied after submucosal instrumentation (SI) vs Submucosal instrumentation (SI) alone, or SI plus placebo/sham aPDT Change in clinical attachment level (CAL) · Adults (> 18 years) with peri-implant mucositis, receiving active treatment Adjunctive antimicrobial photodynamic therapy for treating periodontal and peri‐implant diseases (2024) · Cochrane | 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… | NR | No studies |
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 Pocket closure · Adults (> 18 years) with recurrent periodontitis, receiving supportive (maintenance) periodontal care · 6 months (change from baseline) Adjunctive antimicrobial photodynamic therapy for treating periodontal and peri‐implant diseases (2024) · Cochrane | No studies measured this outcome at 6 months (SoF row labeled 'Change in pocket depth from baseline to 6 months after treatment'); no studies reported these data at six months after treatment. | NR | No studies |
Periodontitis vs No periodontitis (periodontal health or gingivitis) Dental caries (prevalence) · Adults · Age 65 to over 75 years Association between periodontitis and dental caries: a systematic review and meta-analysis. (2024) | OR 1.69 [1.44, 1.98] | 2 studies | Ungraded |
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 Any adverse effect related to aPDT · Adults (> 18 years) with recurrent periodontitis, receiving supportive (maintenance) periodontal care Adjunctive antimicrobial photodynamic therapy for treating periodontal and peri‐implant diseases (2024) · Cochrane | Risk with control: In 1 study, 1 participant had an abscess (not specified if this was related to aPDT). In 2 other studies, no adverse effects of aPDT were observed. Number of participants (studies): 134 (3 RCTs).… | 3 studies · 134 participants | Moderate |
Non-syndromic cleft lip and palate (CLP) status and its oral microbiota (exposure/grouping) vs Children and adolescents aged 0-18 years without CLP (controls) Periodontal/gingival clinical status (gingival index, biofilm index, probing depth, bleeding on probing, attachment loss) · Children and adolescents aged 0-18 years with non-syndromic cleft lip and palate (CLP) Characterization of the oral microbiota and the relationship of the oral microbiota with the dental and… (2024) | Six studies (Ahluwalia, Rawashdeh, Funahashi, Perdikogianni, Quirynen, Costa) reported that patients with CLP had higher gingival index and biofilm/plaque index, deeper probing depth, more bleeding on probing and… | 6 studies | Ungraded |
Periodontitis vs No periodontitis (periodontal health or gingivitis) Crown caries · Adults · Crown caries Association between periodontitis and dental caries: a systematic review and meta-analysis. (2024) | OR 1.03 [1.01, 1.05] | 3 studies | Ungraded |
Dental caries (DT not equal to 0) vs No dental caries Periodontitis (prevalence) · Adults · Overall Association between periodontitis and dental caries: a systematic review and meta-analysis. (2024) | OR 1.79 [1.36, 2.35] | 5 studies | Ungraded |
Oral cancer patients (cases) vs Healthy controls Clinical attachment loss (CAL) in OC cases vs controls · Adults in case-control studies (oral cancer patients vs healthy controls) · Not specified, CAL (clinical attachment loss) Periodontitis and the risk of oral cancer: a meta-analysis of case-control studies. (2024) | SMD 1.94 [0.22, 3.66] | 2 studies | Ungraded |
Single preoperative dose of systemic antibiotics (clindamycin 600 mg), total chemo-mechanical debridement and root filling vs Matched placebo, total chemo-mechanical debridement and root filling Pain at 7 days · Adults with symptomatic apical periodontitis (no signs of spreading infection or systemic involvement) · 7 days Systemic antibiotics for symptomatic apical periodontitis and acute apical abscess in adults (2024) · Cochrane | The median pain at 7 days in the control group was 0 (range 0 to 3); the median pain at 7 days in the intervention group was the same (median 0, range 0 to 1). P = 0.673 (Mann-Whitney U). | 1 study · 72 participants | Low |
Postoperative systemic antibiotics (phenoxymethylpenicillin/penicillin VK, 7-day course), partial or total chemo-mechanical debridement and analgesics vs Matched placebo, partial or total chemo-mechanical debridement and analgesics Endodontic flare-up · Adults with a symptomatic necrotic tooth or localised acute apical abscess (no signs of spreading infection or… · 3 days Systemic antibiotics for symptomatic apical periodontitis and acute apical abscess in adults (2024) · Cochrane | RR 0.27 [0.01, 4.90] | 1 study · 19 participants | Ungraded |
Adjunctive antimicrobial photodynamic therapy (aPDT) applied after submucosal instrumentation (SI) vs Submucosal instrumentation (SI) alone, or SI plus placebo/sham aPDT Change in bleeding on probing (BOP) · Adults (> 18 years) with peri-implant mucositis, receiving active treatment · 3 months (change from baseline) Adjunctive antimicrobial photodynamic therapy for treating periodontal and peri‐implant diseases (2024) · Cochrane | MD 1.60 [0.27, 2.93] | 1 study · 38 participants | Ungraded |
Periodontitis vs No periodontitis (periodontal health or gingivitis) Dental caries (prevalence) · Adults · Moderate periodontitis Association between periodontitis and dental caries: a systematic review and meta-analysis. (2024) | OR 1.38 [1.15, 1.66] | 7 studies | Ungraded |
Periodontitis vs No periodontitis (periodontal health or gingivitis) Dental caries (prevalence) · Adults · Mild periodontitis Association between periodontitis and dental caries: a systematic review and meta-analysis. (2024) | OR 1.65 [0.45, 6.05] | 1 study | Ungraded |
Postoperative systemic antibiotics (phenoxymethylpenicillin/penicillin VK, 7-day course), partial or total chemo-mechanical debridement and analgesics vs Matched placebo, partial or total chemo-mechanical debridement and analgesics Swelling at 7 days · Adults with a symptomatic necrotic tooth or localised acute apical abscess (no signs of spreading infection or… · 7 days Systemic antibiotics for symptomatic apical periodontitis and acute apical abscess in adults (2024) · Cochrane | MD 0.02 [-0.28, 0.32] | 1 study · 41 participants | Very low |
Clear aligners (CA) vs Conventional fixed orthodontic appliances (CF) Plaque accumulation (Plaque Index) · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries) · Range 1 to 18 months (maximum time-point per study), Study design: randomized controlled trials White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared… (2023) | SMD -1.79 [-3.63, 0.04] | 3 studies · 111 participants | Moderate |
Chlorhexidine mouthwash vs Placebo Cariogenic bacteria (Mutans streptococci) · Orthodontic patients · ≤ 3 months The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic… (2023) | Colony count of MS was significantly reduced compared to placebos according to three studies [34; 48; 52]; colony count of MS was slightly reduced compared to placebo in a short time in one study [40]. | 4 studies | Very low |
Clear aligners (CA) vs Conventional fixed orthodontic appliances (CF) Plaque accumulation (Plaque Index) · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries) · 6 months, Follow-up: 6 months White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared… (2023) | SMD -2.04 [-3.37, -0.70] | 5 studies · 253 participants | Ungraded |
Chlorhexidine mouthwash vs Blank control Cariogenic bacteria (Mutans streptococci) · Orthodontic patients · ≤ 3 months The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic… (2023) | Colony count of MS was significantly reduced compared to blank control according to one study [53]; one study reported a significant reduction compared to baseline [51]. | 2 studies | Very low |
Herbal mouthwash vs Placebo Plaque-related index · Orthodontic patients · ≤ 3 months The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic… (2023) | PI was significantly reduced compared to placebo [56]; VPI was significantly reduced compared to placebo [41]; PI was insignificantly reduced compared to placebo [19]. | 3 studies | Low |
Fluoride mouthwash vs Blank control Cariogenic bacteria (Mutans streptococci) · Orthodontic patients · ≤ 3 months The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic… (2023) | Colony count of MS was significantly reduced compared to baseline according to two studies [33; 34]. | 2 studies | Very low |
Chlorhexidine (CHX) mouthwash (adjunct to mechanical cleaning) vs Placebo mouthwash Pocket probing depth (PD) · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances) · <=3 months (short-term) The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic… (2023) | PD was significantly reduced except mid-lingual site compared to placebo [32]. The changes of PD were significantly higher compared to placebo [56]. | 2 studies | Low |
Clear aligners (CA) vs Conventional fixed orthodontic appliances (CF) Incidence of white spot lesions (WSLs) · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries) · End of orthodontic treatment (varying) White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared… (2023) | Not meta-analyzed (heterogeneous methods; tooth-based vs patient-based incidence). 4 studies assessed WSL incidence; 3 (Albhaisi 2020 [12]; Buschang 2019 [29]; Dallel 2020 [30]) reported a lower risk of developing WSLs… | 4 studies | Ungraded |
Chlorhexidine (CHX) mouthwash (adjunct to mechanical cleaning) vs Blank control (no mouthwash; before-after comparison) Plaque Index (PI, Silness & Loe 1964) · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances) · <=3 months (short-term) The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic… (2023) | WMD -0.70 [-1.12, -0.27] | 4 studies · 188 participants | Very low |
Cetylpyridinium chloride (CPC) mouthwash vs Blank control (no mouthwash; before-after comparison) Plaque-related index · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances) · <=3 months (short-term) The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic… (2023) | BBPI was significantly reduced compared to blank control [47]. PI was significantly reduced compared to blank control [50]. The amount of dental plaque was significantly reduced compared to baseline [38]. | 3 studies | Very low |
Herbal mouthwash vs Placebo Cariogenic bacteria (Mutans streptococci) · Orthodontic patients · ≤ 3 months The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic… (2023) | Colony count of MS was significantly reduced compared to placebo [52]; colony count was slightly reduced compared to placebo in a short time in one study [40]. | 2 studies | Very low |
Fluoride mouthwash (e.g., NaF / amine fluoride) vs Blank control (no mouthwash; before-after comparison) Gingival inflammation-related index · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances) · <=3 months (short-term) The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic… (2023) | MGI' and BI' was significantly reduced compared to baseline [34]. BOP and GI was slightly lower compared to blank control [46]. | 2 studies | Very low |
Fluoride mouthwash vs Blank control Plaque-related index · Orthodontic patients · ≥ 12 months The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic… (2023) | PI was similar to blank control [37]; API was slightly reduced compared to blank control and significant at 6 and 9 months [59]. | 2 studies | Very low |
Clear aligners (CA) vs Conventional fixed orthodontic appliances (CF) Plaque accumulation (Plaque Index) · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries) · Range 1 to 12 months (maximum time-point per study), Study design: non-randomized studies of interventions White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared… (2023) | SMD -1.46 [-2.77, -0.15] | 5 studies · 246 participants | Moderate |
Fluoride mouthwash (e.g., NaF / amine fluoride) vs Blank control (no mouthwash; before-after comparison) Cariogenic bacteria (Lactobacilli colony count) · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances) · >=12 months (long-term) The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic… (2023) | Colony count of LB was similar to blank control according to two studies [37, 59]. | 2 studies | Very low |
Clear aligners (CA) vs Conventional fixed orthodontic appliances (CF) Severity of white spot lesions (surface area and depth) · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries) · Baseline to end of treatment (varying) White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared… (2023) | Not meta-analyzed. 2 RCTs assessed WSL severity by lesion surface area (Albhaisi 2020 [12]; Alshatti 2017 [31]) and 1 (Albhaisi 2020 [12]) also by lesion depth; reported narratively with differing methods, generally… | 2 studies | Ungraded |
Chlorhexidine (CHX) mouthwash (adjunct to mechanical cleaning) vs Blank control (no mouthwash; before-after comparison) Gingival Index (GI, Loe & Silness 1963) · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances) · <=3 months (short-term) The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic… (2023) | WMD -0.54 [-0.96, -0.13] | 6 studies · 274 participants | Very low |
Herbal mouthwash vs Placebo Gingival inflammation-related index · Orthodontic patients · ≤ 3 months The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic… (2023) | GBI was significantly reduced compared to placebo [41]; GBI was significantly reduced compared to placebo [56]; BI was significantly reduced compared to placebo [40]. | 3 studies | Very low |
Herbal / plant-extract mouthwash (e.g., essential oils, Persica, propolis, Azadirachta indica, chamomile, Aloe vera) vs Blank control (no mouthwash; before-after comparison) Gingival Index (GI, Loe & Silness 1963) · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances) · <=3 months (short-term) The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic… (2023) | WMD -0.20 [-0.32, -0.09] | 3 studies · 132 participants | Moderate |
Chlorhexidine mouthwash vs Placebo Plaque Index · Orthodontic patients · ≤ 3 months The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic… (2023) | Plaque Index was significantly reduced compared to placebos according to two studies [20; 32]. | 2 studies | Very low |
Fluoride mouthwash vs Blank control Cariogenic bacteria (Mutans streptococci) · Orthodontic patients · ≥ 12 months The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic… (2023) | Colony count of MS was similar to blank control according to two studies [37; 59]. | 2 studies | Very low |
Clear aligners (CA) vs Conventional fixed orthodontic appliances (CF) Salivary caries-associated bacteria (S. mutans and Lactobacilli, subjects with >10^5 CFU/mL) · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries) · 3 and 6 months White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared… (2023) | Not meta-analyzed (insufficient number of studies). Both included observational studies (Mummolo 2020 [19]; Mummolo 2020 [25]) reported a higher number of subjects with S. mutans and Lactobacilli >10^5 CFU/mL in the… | 2 studies | Ungraded |
Probiotic mouthwash (e.g., Lactobacillus-based) vs Blank control (no mouthwash; before-after comparison) Cariogenic bacteria (Mutans streptococci colony count) · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances) · <=3 months (short-term) The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic… (2023) | Colony count of MS was significantly reduced compared to blank control [53]. Colony count of MS was insignificantly increased compared to baseline [33]. | 2 studies | Very low |
Fluoride mouthwash vs Blank control Plaque-related index · Orthodontic patients · ≤ 3 months The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic… (2023) | TI was significantly reduced compared to baseline [34]; PI was significantly reduced compared to baseline but similar to blank control [46]. | 2 studies | Very low |
Clear aligners (CA) vs Conventional fixed orthodontic appliances (CF) Plaque accumulation (Plaque Index) · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries) · 3 months, Follow-up: 3 months White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared… (2023) | SMD -1.08 [-1.93, -0.24] | 5 studies · 211 participants | Ungraded |
Chlorhexidine (CHX) mouthwash (adjunct to mechanical cleaning) vs Placebo mouthwash Gingival Index (GI, Loe & Silness 1963) · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances) · <=3 months (short-term) The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic… (2023) | WMD -0.45 [-0.70, -0.20] | 3 studies · 98 participants | Low |
Clear aligners (CA) vs Conventional fixed orthodontic appliances (CF) Plaque accumulation (Plaque Index) · Orthodontic patients undergoing comprehensive treatment (late mixed or permanent dentition, no active caries) · Maximum reported time-point per study (range 1-18 months) White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared… (2023) | SMD -1.58 [-2.57, -0.58] | 8 studies · 357 participants | Ungraded |
Periodontal disease (periodontitis; clinical attachment loss >=4 mm) vs Adults without periodontal disease (healthy periodontal status; CAL <=3 mm) Root caries (presence of root caries) · Adults (mean age ~53 years) Is there an association between periodontal disease and root caries? A systematic review and meta-analysis. (2023) | OR 1.38 [1.25, 1.53] | 2 studies · 7664 participants | Low |
Herbal mouthwash vs Blank control Plaque-related index · Orthodontic patients · ≤ 3 months The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic… (2023) | PI was significantly reduced compared to baseline [39; 48; 54; 58]; BBPI was significantly reduced compared to blank control [47]; TI and dental plaque amount were significantly reduced compared to baseline [45; 38]. | 8 studies | Very low |