Cochrane · intervention · CD009376

Supportive periodontal therapy (SPT) for maintaining the dentition in adults treated for periodontitis

Manresa, C, Sanz‐Miralles, EC, Twigg, J, et al. · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library

Oral Health Periodontology2 versionsAMSTAR 2: not assessed

Full textEvery question was extracted from the full review (methods and results), not only its Summary of Findings table.

Questions

current version

GRADE rated

No studies

Included studies

as reported

No studies 9 · 50%Ungraded 2 · 11.1%Very low 5 · 27.8%Low 2 · 11.1%Moderate 0 · 0%High 0 · 0%

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.

Review question

Element	Planned (methods)	Found (results)
Population	Adult participants (18 years or older) previously treated for periodontal disease and now in the maintenance phase; treatment of active disease should have been concluded at least six months prior to randomisation to ensure participants were periodontally stable and compliant	Four studies with 307 participants aged 31 to 85 years, previously treated for moderate to severe chronic periodontitis and recruited from an SPT programme (Preshaw 2005 at least 31 years; Tonetti 2012 at least 35 years; Lulic 2009 and Killeen 2016 at least 40 years)
Intervention	SPT performed by periodontal specialists versus non-specialist dental professionals; SPT versus monitoring only, or alternative interventions that do not include mechanical debridement; SPT with and without adjunctive interventions delivered by dental professional or self-administered; SPT performed using different techniques and appliances for mechanical root debridement; SPT provided at different time intervals	SPT performed by specialists (n=1, Preshaw 2005); Mechanical debridement plus local antibiotic (n=2; Killeen 2016 minocycline microspheres, Tonetti 2012 doxycycline gel); Photodynamic therapy as an adjunct to mechanical debridement (n=1, Lulic 2009)
Comparison	Non-specialist dental professionals; Monitoring only; Alternative interventions that do not include mechanical debridement; With and without adjunctive interventions; Different techniques and appliances for mechanical root debridement; Different time intervals of SPT	SPT performed by non-specialist clinicians / general dental practitioners (n=1); Mechanical debridement alone (n=3)
Outcomes	Primary outcomes: Tooth loss; Bleeding on probing (BoP); Clinical attachment level (CAL); Adverse events. Secondary outcomes: Probing pocket depth (PPD); Patient-reported outcome measures (e.g. satisfaction with treatment); Cost-effectiveness of SPT related to overall dental care with or without SPT; Cost-effectiveness of SPT related to the frequency of SPT	Tooth loss (n=0, not measured); Bleeding on probing (n=2 usable); Clinical attachment level (n=2); Probing pocket depth (n=4); Adverse events (n=2)
Study designs	Randomised controlled trials (RCTs) with at least 12 months of follow-up; split-mouth studies with a risk of contamination were excluded	Randomised controlled trials (n=4)
Timing	At least 12 months of follow-up. Follow-up was considered as the period of SPT in which the interventions were compared; it started following completion of active periodontal therapy or when participants had already been enrolled in a periodontal maintenance programme	All four studies had a follow-up of at least 12 months

Search date: 2017-05. Databases: Cochrane Oral Health's Trials Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE Ovid; Embase Ovid