What do systematic reviews say?

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

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

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 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

• Full‐mouth treatment modalities (within 24 hours) for periodontitis in adults 2022 · Cochrane All outcomes
  Pocket closure (sites with PPD <=4 mm after treatment): 9 studies reported; all showed increased closed pockets after treatment; 8 of 9 found no between-group difference; Koshy 2005 found a greater change in both…
  9 studies
  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

Azithromycin + SRP vs SRP

Azithromycin + SRP led to lower 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 -0.57 [-1.08, -0.07]
  6 studies · 216 participants
  GRADE not reported
• Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes

  Long-term (≥ 1 year)
  MD -0.77 [-2.33, 0.79]
  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 -0.60 [-1.02, -0.18]
  7 studies · 258 participants
  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

Metronidazole + SRP vs SRP

It is very uncertain whether metronidazole + SRP changes probing pocket depth 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 -1.11 [-2.84, 0.61]
  2 studies · 47 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 -0.59 [-0.95, -0.23]
  4 studies · 94 participants
  GRADE not reported
• Adjunctive systemic antimicrobials for the non‐surgical treatment of periodontitis 2020 · Cochrane All outcomes

  Short-term (≤ 3 months)
  MD -0.10 [-0.37, 0.16]
  4 studies · 108 participants
  GRADE not reported