Non-Cochrane · intervention · PM42126682
Efficacy of subgingival irrigation with chemical agents as adjuvants to non-surgical periodontal therapy: systematic review and meta-analysis.
da Silveira Marcela Iunes, Maciel Clarissa Carvalho Martins, Grant Melissa M, et al. · Clinical oral investigations · 2026 · PubMed · doi:10.1007/s00784-026-06909-5
Findings
Population Patients with periodontitis without systemic conditions
21 findings
| Subgingival irrigation with chemical agents (any) adjunctive to NSPT | NSPT with water or saline irrigation (control) | Clinical attachment level change 3 to 12 months | MD 0.09 [0.00, 0.18] Low Downgraded: risk of bias, imprecision 12 studies · 546 participants |
| Subgingival irrigation with chemical agents (any) adjunctive to NSPT | NSPT with water or saline irrigation (control) | Probing pocket depth change 3 to 12 months · Teeth with furcation involvement (Ribeiro 2010, Ribeiro 2006, Yilmaz 2012) | MD 0.02 [-0.44, 0.48] GRADE not reported 3 studies |
| Subgingival irrigation with chemical agents (any) adjunctive to NSPT | NSPT with water or saline irrigation (control) | Clinical attachment level change 3 to 12 months · Teeth with furcation involvement (Ribeiro 2010, Ribeiro 2006, Yilmaz 2012) | MD -0.08 [-0.53, 0.38] GRADE not reported 3 studies |
| Subgingival irrigation with chemical agents (any) adjunctive to NSPT | NSPT with water or saline irrigation (control) | Clinical attachment level change 12 months · 12-month follow-up; studies not evaluating furcation involvement | MD 0.25 [0.09, 0.40] GRADE not reported 2 studies |
| Subgingival irrigation with chemical agents (any) adjunctive to NSPT | NSPT with water or saline irrigation (control) | Bleeding on probing change 3 to 12 months · Teeth with furcation involvement (Ribeiro 2010, Ribeiro 2006, Yilmaz 2012) | MD 0.56 [-6.98, 8.11] GRADE not reported 3 studies |
| Subgingival irrigation with chemical agents (any) adjunctive to NSPT | NSPT with water or saline irrigation (control) | Probing pocket depth change 3 to 12 months | MD 0.01 [-0.11, 0.14] Low Downgraded: risk of bias, imprecision, inconsistency 11 studies · 515 participants |
| Subgingival irrigation with chemical agents (any) adjunctive to NSPT | NSPT with water or saline irrigation (control) | Bleeding on probing change 3 to 12 months | MD -1.48 [-5.84, 2.88] Very low Downgraded: risk of bias, imprecision 7 studies · 395 participants |
| Subgingival irrigation with povidone-iodine adjunctive to NSPT | NSPT with water or saline irrigation (control) | Clinical attachment level change 3 to 12 months | MD 0.12 [-0.07, 0.32] GRADE not reported 7 studies · 310 participants |
| Subgingival irrigation with povidone-iodine adjunctive to NSPT | NSPT with water or saline irrigation (control) | Probing pocket depth change 3 to 12 months | MD -0.10 [-0.25, 0.04] GRADE not reported 6 studies · 270 participants |
| Subgingival irrigation with povidone-iodine adjunctive to NSPT | NSPT with water or saline irrigation (control) | Bleeding on probing change 3 to 12 months | MD -4.48 [-13.99, 5.03] GRADE not reported 3 studies · 200 participants |
| Subgingival irrigation with chlorhexidine adjunctive to NSPT | NSPT with water or saline irrigation (control) | Probing pocket depth change 3 to 12 months | MD -0.02 [-0.22, 0.19] GRADE not reported 3 studies · 91 participants |
| Subgingival irrigation with chlorhexidine adjunctive to NSPT | NSPT with water or saline irrigation (control) | Bleeding on probing change 3 to 12 months | MD -0.13 [-8.47, 8.21] GRADE not reported 2 studies · 71 participants |
| Subgingival irrigation with chlorhexidine adjunctive to NSPT | NSPT with water or saline irrigation (control) | Clinical attachment level change 3 to 12 months | MD 0.02 [-0.14, 0.17] GRADE not reported 3 studies · 82 participants |
| Subgingival irrigation with essential oils adjunctive to NSPT | NSPT with water or saline irrigation (control) | Bleeding on probing change 3 to 12 months | MD 0.33 [-9.43, 10.10] GRADE not reported 2 studies · 83 participants |
| Subgingival irrigation with essential oils adjunctive to NSPT | NSPT with water or saline irrigation (control) | Probing pocket depth change 3 to 12 months | MD 0.28 [-0.08, 0.63] GRADE not reported 2 studies · 83 participants |
| Subgingival irrigation with essential oils adjunctive to NSPT | NSPT with water or saline irrigation (control) | Clinical attachment level change 3 to 12 months | MD 0.11 [-0.18, 0.40] GRADE not reported 2 studies · 83 participants |
| Subgingival irrigation with boric acid adjunctive to NSPT | NSPT with water or saline irrigation (control) | Clinical attachment level change 3 to 12 months | MD 0.02 [-0.17, 0.21] GRADE not reported 1 study · 30 participants |
| Subgingival irrigation with boric acid adjunctive to NSPT | NSPT with water or saline irrigation (control) | Probing pocket depth change 3 to 12 months | MD 0.02 [-0.17, 0.21] GRADE not reported 1 study · 30 participants |
| Subgingival irrigation with ozonated water adjunctive to NSPT | NSPT with water or saline irrigation (control) | Bleeding on probing change 3 to 12 months | MD 6.00 [-8.33, 20.33] GRADE not reported 1 study · 41 participants |
| Subgingival irrigation with ozonated water adjunctive to NSPT | NSPT with water or saline irrigation (control) | Probing pocket depth change 3 to 12 months | MD 0.40 [0.17, 0.63] GRADE not reported 1 study · 41 participants |
| Subgingival irrigation with ozonated water adjunctive to NSPT | NSPT with water or saline irrigation (control) | Clinical attachment level change 3 to 12 months | MD -0.20 [-0.89, 0.49] GRADE not reported 1 study · 41 participants |
Included primary studies 16
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Al Habashneh 2015 Ozone as an adjunct to conventional nonsurgical therapy in chronic periodontitis: a randomized controlled clinical trial. PMID:24665871 | 2015 | 1 other review | not stated | not extracted yet |
| Al-Saeed and Babay 2009 The use of povidone-iodine and hydrogen peroxide mixture as an adjunct to non-surgical treatment of slight to moderate chronic… PMID:23960471 | 2009 | this review only | not stated | not extracted yet |
| Chapple 1992 Effect of subgingival irrigation with chlorhexidine during ultrasonic scaling. PMID:1403587 | 1992 | this review only | not stated | not extracted yet |
| Cosyn 2013 Clinical effects of an essential oil solution used as a coolant during ultrasonic root debridement. PMID:22520627 | 2013 | this review only | not stated | not extracted yet |
| do Vale 2016 Full-mouth ultrasonic debridement associated with povidone iodine rinsing in GAgP treatment: a randomised clinical trial. PMID:25875425 | 2016 | this review only | not stated | not extracted yet |
| Feng 2011 Subgingival ultrasonic instrumentation of residual pockets irrigated with essential oils: a randomized controlled trial. PMID:21449990 | 2011 | this review only | not stated | not extracted yet |
| Kruck 2012 Clinical and microbiologic results 12 months after scaling and root planing with different irrigation solutions in patients with moderate… PMID:21749169 | 2012 | this review only | not stated | not extracted yet |
| Leonhardt 2006 Healing following ultrasonic debridement and PVP-iodine in individuals with severe chronic periodontal disease: a randomized, controlled… PMID:16945890 | 2006 | this review only | not stated | not extracted yet |
| Perrella 2016 Clinical and Microbiological Evaluation of Povidone-Iodine 10% as an Adjunct to Nonsurgical Periodontal Therapy in Chronic Periodontitis:… PMID:31473699 | 2016 | this review only | not stated | not extracted yet |
| Ribeiro 2006 Povidone-iodine used as an adjunct to non-surgical treatment of furcation involvements. PMID:16460246 | 2006 | this review only | not stated | not extracted yet |
| Ribeiro 2010 Non-surgical instrumentation associated with povidone-iodine in the treatment of interproximal furcation involvements. PMID:21308291 | 2010 | this review only | not stated | not extracted yet |
| Rosling 2001 The use of PVP-iodine as an adjunct to non-surgical treatment of chronic periodontitis. PMID:11686823 | 2001 | this review only | not stated | not extracted yet |
| Saglam 2013 Boric acid irrigation as an adjunct to mechanical periodontal therapy in patients with chronic periodontitis: a randomized clinical trial. PMID:23121460 | 2013 | this review only | not stated | not extracted yet |
| Vitt 2019 Polyhexamethylene guanidine phosphate irrigation as an adjunctive to scaling and root planing in the treatment of chronic periodontitis. PMID:30632852 | 2019 | this review only | not stated | not extracted yet |
| Yilmaz 2012 Clinical evaluation of chlorhexidine and essential oils for adjunctive effects in ultrasonic instrumentation of furcation involvements: a… PMID:22212113 | 2012 | this review only | not stated | not extracted yet |
| Zanatta 2006 Periodontal debridement with povidone-iodine in periodontal treatment: short-term clinical and biochemical observations. PMID:16512765 | 2006 | this review only | not stated | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
| Review | Shared studies | Jaccard |
|---|---|---|
| Oxygen-Based Adjunct Therapies in Periodontitis: A Systematic Review and Meta-Analysis Within the Framework of Hypoxia and Inflammation. (2025) | 1 | 0.02 |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients with periodontitis without systemic conditions | Periodontitis patients (n=712; 26 to 72 years) |
| Intervention | NSPT plus chemical agent in subgingival irrigation (syringe or ultrasonic device) | PVP-I, chlorhexidine, essential oils, ozonated water, boric acid irrigation with NSPT (16 RCTs) |
| Comparison | NSPT alone or with water or saline irrigation | Water, saline or distilled water irrigation with NSPT |
| Outcomes | PPD reduction (primary); CAL gain and BOP change (secondary) | PPD change (11 trials), CAL change (12 trials), BOP change (7 trials); adverse effects and PROs narratively |
| Study designs | RCTs with at least 3 months follow-up | 16 RCTs (13 parallel, 3 split-mouth) |
| Timing | At least 3 months | 3 to 12 months (7 at 3 months, 6 at 6 months, 3 at 12 months) |