Non-Cochrane · intervention · PM42451212
Resveratrol as an Adjunct Therapy in Periodontal Disease: A Systematic Review and Meta-Analysis.
Su Suzanne Ying-Shan, Tzeng I-Shiang, Huang Ting-Hsin, et al. · Nutrients · 2026 · PubMed · doi:10.3390/nu18132212
Findings
38 findings
| Population | ||||
|---|---|---|---|---|
| Periodontal-related cells (PDL cells, gingival fibroblasts, PBMCs, macrophages) stimulated with LPS | Resveratrol (any formulation or concentration) | LPS stimulation without resveratrol | TNF-α protein expression In vitro cell models · Leave-one-out sensitivity analysis: omitting Shi 2021 | SMD -2.68 [-4.58, -0.78] GRADE not reported 3 studies |
| Periodontal-related cells (PDL cells, gingival fibroblasts, PBMCs, macrophages) stimulated with LPS | Resveratrol (any formulation or concentration) | LPS stimulation without resveratrol | IL-1β protein expression In vitro cell models | SMD -3.50 [-5.50, -1.51] GRADE not reported 4 studies · 24 participants |
| Periodontal-related cells (PDL cells, gingival fibroblasts, PBMCs, macrophages) stimulated with LPS | Resveratrol (any formulation or concentration) | LPS stimulation without resveratrol | IL-6 protein expression In vitro cell models · Leave-one-out sensitivity analysis: omitting Fordham 2014 | SMD -2.52 [-4.54, -0.49] GRADE not reported 3 studies |
| Periodontal-related cells (PDL cells, gingival fibroblasts, PBMCs, macrophages) stimulated with LPS | Resveratrol (any formulation or concentration) | LPS stimulation without resveratrol | IL-1β protein expression In vitro cell models · Leave-one-out sensitivity analysis: omitting Shi 2021 | SMD -3.21 [-5.25, -1.17] GRADE not reported 3 studies |
| Periodontal-related cells (PDL cells, gingival fibroblasts, PBMCs, macrophages) stimulated with LPS | Resveratrol (any formulation or concentration) | LPS stimulation without resveratrol | IL-6 protein expression In vitro cell models | SMD -3.33 [-5.80, -0.86] GRADE not reported 4 studies · 24 participants |
| Periodontal-related cells (PDL cells, gingival fibroblasts, PBMCs, macrophages) stimulated with LPS | Resveratrol (any formulation or concentration) | LPS stimulation without resveratrol | IL-1β protein expression In vitro cell models · Leave-one-out sensitivity analysis: common-effect model, all studies | SMD -3.50 [-5.49, -1.51] GRADE not reported 4 studies |
| Periodontal-related cells (PDL cells, gingival fibroblasts, PBMCs, macrophages) stimulated with LPS | Resveratrol (any formulation or concentration) | LPS stimulation without resveratrol | IL-6 protein expression In vitro cell models · Leave-one-out sensitivity analysis: omitting Shi 2021 | SMD -2.46 [-4.30, -0.63] GRADE not reported 3 studies |
| Periodontal-related cells (PDL cells, gingival fibroblasts, PBMCs, macrophages) stimulated with LPS | Resveratrol (any formulation or concentration) | LPS stimulation without resveratrol | TNF-α protein expression In vitro cell models · Leave-one-out sensitivity analysis: omitting Park 2013 | SMD -2.56 [-4.50, -0.62] GRADE not reported 3 studies |
| Periodontal-related cells (PDL cells, gingival fibroblasts, PBMCs, macrophages) stimulated with LPS | Resveratrol (any formulation or concentration) | LPS stimulation without resveratrol | IL-6 protein expression In vitro cell models · Leave-one-out sensitivity analysis: common-effect model, all studies | SMD -2.75 [-4.53, -0.96] GRADE not reported 4 studies |
| Periodontal-related cells (PDL cells, gingival fibroblasts, PBMCs, macrophages) stimulated with LPS | Resveratrol (any formulation or concentration) | LPS stimulation without resveratrol | IL-1β protein expression In vitro cell models · Leave-one-out sensitivity analysis: omitting Park 2013 | SMD -3.59 [-5.99, -1.19] GRADE not reported 3 studies |
| Periodontal-related cells (PDL cells, gingival fibroblasts, PBMCs, macrophages) stimulated with LPS | Resveratrol (any formulation or concentration) | LPS stimulation without resveratrol | IL-6 protein expression In vitro cell models · Leave-one-out sensitivity analysis: omitting Rizzo 2012 | SMD -2.44 [-4.29, -0.58] GRADE not reported 3 studies |
| Periodontal-related cells (PDL cells, gingival fibroblasts, PBMCs, macrophages) stimulated with LPS | Resveratrol (any formulation or concentration) | LPS stimulation without resveratrol | IL-1β protein expression In vitro cell models · Leave-one-out sensitivity analysis: omitting Fordham 2014 | SMD -4.18 [-6.84, -1.52] GRADE not reported 3 studies |
| Periodontal-related cells (PDL cells, gingival fibroblasts, PBMCs, macrophages) stimulated with LPS | Resveratrol (any formulation or concentration) | LPS stimulation without resveratrol | TNF-α protein expression In vitro cell models · Leave-one-out sensitivity analysis: common-effect model, all studies | SMD -2.87 [-4.76, -0.99] GRADE not reported 4 studies |
| Periodontal-related cells (PDL cells, gingival fibroblasts, PBMCs, macrophages) stimulated with LPS | Resveratrol (any formulation or concentration) | LPS stimulation without resveratrol | IL-1β protein expression In vitro cell models · Leave-one-out sensitivity analysis: omitting Rizzo 2012 | SMD -3.30 [-5.52, -1.07] GRADE not reported 3 studies |
| Periodontal-related cells (PDL cells, gingival fibroblasts, PBMCs, macrophages) stimulated with LPS | Resveratrol (any formulation or concentration) | LPS stimulation without resveratrol | IL-8 protein expression In vitro cell models | SMD -3.21 [-5.82, -0.61] GRADE not reported 2 studies · 12 participants |
| Periodontal-related cells (PDL cells, gingival fibroblasts, PBMCs, macrophages) stimulated with LPS | Resveratrol (any formulation or concentration) | LPS stimulation without resveratrol | TNF-α protein expression In vitro cell models | SMD -3.40 [-6.22, -0.57] GRADE not reported 4 studies · 24 participants |
| Periodontal-related cells (PDL cells, gingival fibroblasts, PBMCs, macrophages) stimulated with LPS | Resveratrol (any formulation or concentration) | LPS stimulation without resveratrol | TNF-α protein expression In vitro cell models · Leave-one-out sensitivity analysis: omitting Fordham 2014 | SMD -3.40 [-6.01, -0.79] GRADE not reported 3 studies |
| Periodontal-related cells (PDL cells, gingival fibroblasts, PBMCs, macrophages) stimulated with LPS | Resveratrol (any formulation or concentration) | LPS stimulation without resveratrol | TNF-α protein expression In vitro cell models · Leave-one-out sensitivity analysis: omitting Rizzo 2012 | SMD -3.25 [-5.80, -0.71] GRADE not reported 3 studies |
| Periodontal-related cells (PDL cells, gingival fibroblasts, PBMCs, macrophages) stimulated with LPS | Resveratrol (any formulation or concentration) | LPS stimulation without resveratrol | IL-6 protein expression In vitro cell models · Leave-one-out sensitivity analysis: omitting Shahidi 2017 | SMD -4.83 [-7.84, -1.82] GRADE not reported 3 studies |
| Animals with ligature-induced periodontitis | Resveratrol | Periodontitis model without resveratrol (placebo or untreated) | IL-1β protein expression in gingiva In vivo animal models (rats, mice) | SMD -0.87 [-1.49, -0.25] GRADE not reported 2 studies · 44 participants |
| Animals with ligature-induced periodontitis | Resveratrol | Periodontitis model without resveratrol (placebo or untreated) | Alveolar bone crest level (CEJ to bone crest distance, mm) In vivo animal models (rats, mice) · Leave-one-out sensitivity analysis: omitting Correa 2017 | MD -0.10 [-0.12, -0.08] GRADE not reported 3 studies |
| Animals with ligature-induced periodontitis | Resveratrol | Periodontitis model without resveratrol (placebo or untreated) | TNF-α mRNA relative expression in gingiva In vivo animal models (rats, mice) | SMD -5.00 [-12.11, 2.12] GRADE not reported 3 studies · 24 participants |
| Animals with ligature-induced periodontitis | Resveratrol | Periodontitis model without resveratrol (placebo or untreated) | Alveolar bone crest level (CEJ to bone crest distance, mm) In vivo animal models (rats, mice) | MD -0.10 [-0.11, -0.08] GRADE not reported 4 studies · 62 participants |
| Animals with ligature-induced periodontitis | Resveratrol | Periodontitis model without resveratrol (placebo or untreated) | Alveolar bone crest level (CEJ to bone crest distance, mm) In vivo animal models (rats, mice) · Leave-one-out sensitivity analysis: omitting Shi 2021 | MD -0.10 [-0.12, -0.08] GRADE not reported 3 studies |
| Animals with ligature-induced periodontitis | Resveratrol | Periodontitis model without resveratrol (placebo or untreated) | Alveolar bone crest level (CEJ to bone crest distance, mm) In vivo animal models (rats, mice) · Leave-one-out sensitivity analysis: omitting Tamaki 2014 | MD -0.10 [-0.14, -0.06] GRADE not reported 3 studies |
| Animals with ligature-induced periodontitis | Resveratrol | Periodontitis model without resveratrol (placebo or untreated) | IL-1β mRNA relative expression in gingiva In vivo animal models (rats, mice) | SMD -7.73 [-14.80, -0.66] GRADE not reported 3 studies · 24 participants |
| Animals with ligature-induced periodontitis | Resveratrol | Periodontitis model without resveratrol (placebo or untreated) | IL-6 mRNA relative expression in gingiva In vivo animal models (rats, mice) | SMD -6.90 [-14.61, 0.81] GRADE not reported 3 studies · 24 participants |
| Animals with ligature-induced periodontitis | Resveratrol | Periodontitis model without resveratrol (placebo or untreated) | Alveolar bone crest level (CEJ to bone crest distance, mm) In vivo animal models (rats, mice) · Leave-one-out sensitivity analysis: omitting Casati 2013 | MD -0.10 [-0.12, -0.08] GRADE not reported 3 studies |
| Animals with ligature-induced periodontitis | Resveratrol | Periodontitis model without resveratrol (placebo or untreated) | Alveolar bone crest level (CEJ to bone crest distance, mm) In vivo animal models (rats, mice) · Leave-one-out sensitivity analysis: common-effect model, all studies | MD -0.10 [-0.12, -0.08] GRADE not reported 4 studies |
| Systemically healthy non-smoking patients with periodontitis | Adjunctive resveratrol (oral, gel, mouthwash) with scaling and root planing | Scaling and root planing alone or with placebo | Clinical attachment level (mm) Post-treatment time point most comparable across trials · Human clinical trials | MD -0.26 [-0.51, 0] Low Downgraded: imprecision 3 studies · 119 participants |
| Systemically healthy non-smoking patients with periodontitis | Adjunctive resveratrol (oral, gel, mouthwash) with scaling and root planing | Scaling and root planing alone or with placebo | Probing pocket depth (mm) Post-treatment time point most comparable across trials · Human clinical trials | MD -0.50 [-0.72, -0.28] Moderate Downgraded: imprecision 3 studies · 119 participants |
| Systemically healthy non-smoking patients with gingivitis or periodontitis | Adjunctive resveratrol (oral, gel, spray, mouthwash) with non-surgical periodontal therapy or plaque control | Non-surgical periodontal therapy or plaque control alone, or placebo | Bleeding index (%) Human clinical trials · Leave-one-out sensitivity analysis: common-effect model, all studies | MD -7.72 [-9.13, -6.32] GRADE not reported 4 studies |
| Systemically healthy non-smoking patients with gingivitis or periodontitis | Adjunctive resveratrol (oral, gel, spray, mouthwash) with non-surgical periodontal therapy or plaque control | Non-surgical periodontal therapy or plaque control alone, or placebo | Bleeding index (%) Human clinical trials · Leave-one-out sensitivity analysis: omitting Nikniaz 2023 | MD -8.11 [-9.57, -6.64] GRADE not reported 3 studies |
| Systemically healthy non-smoking patients with gingivitis or periodontitis | Adjunctive resveratrol (oral, gel, spray, mouthwash) with non-surgical periodontal therapy or plaque control | Non-surgical periodontal therapy or plaque control alone, or placebo | Bleeding index (%) Human clinical trials · Leave-one-out sensitivity analysis: omitting Berta 2021 | MD -6.79 [-9.06, -4.51] GRADE not reported 3 studies |
| Systemically healthy non-smoking patients with gingivitis or periodontitis | Adjunctive resveratrol (oral, gel, spray, mouthwash) with non-surgical periodontal therapy or plaque control | Non-surgical periodontal therapy or plaque control alone, or placebo | Bleeding index (%) Human clinical trials · Leave-one-out sensitivity analysis: omitting Golshah 2021 | MD -8.95 [-10.47, -7.43] GRADE not reported 3 studies |
| Systemically healthy non-smoking patients with gingivitis or periodontitis | Adjunctive resveratrol (oral, gel, spray, mouthwash) with non-surgical periodontal therapy or plaque control | Non-surgical periodontal therapy or plaque control alone, or placebo | Bleeding index (%) Human clinical trials · Leave-one-out sensitivity analysis: omitting Mohammed 2025 | MD -6.50 [-8.02, -4.97] GRADE not reported 3 studies |
| Systemically healthy non-smoking patients with gingivitis or periodontitis | Adjunctive resveratrol (oral, gel, spray, mouthwash) with non-surgical periodontal therapy or plaque control | Non-surgical periodontal therapy or plaque control alone, or placebo | Bleeding index (%) Post-treatment time point most comparable across trials · Human clinical trials Unresolved: the two extractors disagree on this row. | MD -6.82 [-12.12, -1.53] Low Downgraded: imprecision, inconsistency 4 studies · 187 participants |
| Systemically healthy non-smoking patients with gingivitis or periodontitis | Adjunctive resveratrol (oral, gel, spray, mouthwash) with non-surgical periodontal therapy or plaque control | Non-surgical periodontal therapy or plaque control alone, or placebo | Plaque index (%) Post-treatment time point most comparable across trials · Human clinical trials Unresolved: the two extractors disagree on this row. | MD -12.61 [-16.41, -8.80] Low Downgraded: imprecision, inconsistency 3 studies · 143 participants |
Included primary studies 27
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Mohammed 2025 Evaluating the Efficacy of Resveratrol-Containing Mouthwash as an Adjunct Treatment for Periodontitis: A Randomized Clinical Trial. PMID:39251207 | 2025 | 1 other review | Probing pocket depth (mm); Clinical attachment level (mm); Bleeding index (%); Plaque index (%) | not extracted yet |
| Nikniaz 2023 Impact of resveratrol supplementation on clinical parameters and inflammatory markers in patients with chronic periodontitis: a randomized… PMID:36973728 | 2023 | 1 other review | Probing pocket depth (mm); Clinical attachment level (mm); Bleeding index (%); Plaque index (%) | not extracted yet |
| Berta 2021 An Innovative Strategy for Oral Biofilm Control in Early Childhood Based on a Resveratrol-Cyclodextrin Nanotechnology Approach. PMID:34300720 | 2021 | this review only | Bleeding index (%); Plaque index (%) | not extracted yet |
| Casati 2013 Resveratrol Decreases Periodontal Breakdown and Modulates Local Levels of Cytokines During Periodontitis in Rats DOI:10.1902/jop.2013.120746 | 2013 | this review only | not stated | not extracted yet |
| Casati 2013 Resveratrol decreases periodontal breakdown and modulates local levels of cytokines during periodontitis in rats. PMID:23489233 | 2013 | this review only | Alveolar bone crest level (CEJ to bone crest distance, mm); IL-1β protein expression in gingiva | not extracted yet |
| Correa 2017 Systemic treatment with resveratrol and/or curcumin reduces the progression of experimental periodontitis in rats. PMID:27135637 | 2017 | this review only | Alveolar bone crest level (CEJ to bone crest distance, mm); IL-1β protein expression in gingiva | not extracted yet |
| Corrêa 2017 Systemic treatment with resveratrol and/or curcumin reduces the progression of experimental periodontitis in rats DOI:10.1111/jre.12382 | 2016 | this review only | not stated | not extracted yet |
| Fordham 2014 Leukocyte Production of Inflammatory Mediators Is Inhibited by the Antioxidants Phloretin, Silymarin, Hesperetin, and Resveratrol DOI:10.1155/2014/938712 | 2014 | this review only | not stated | not extracted yet |
| Fordham 2014 Leukocyte production of inflammatory mediators is inhibited by the antioxidants phloretin, silymarin, hesperetin, and resveratrol. PMID:24707119 | 2014 | this review only | IL-1β protein expression; IL-6 protein expression; TNF-α protein expression | not extracted yet |
| Golshah 2021 Gingivitis Effectiveness of Emulgel Containing 2% Resveratrol in Orthodontic Patients: An 8-Week Randomized Clinical Trial DOI:10.1155/2021/6615900 | 2021 | this review only | not stated | not extracted yet |
| Golshah 2021 Gingivitis Effectiveness of Emulgel Containing 2% Resveratrol in Orthodontic Patients: An 8-Week Randomized Clinical Trial. PMID:33859693 | 2021 | this review only | Bleeding index (%) | not extracted yet |
| Huangfu 2023 Facile engineering of resveratrol nanoparticles loaded with 20(S)-protopanaxadiol for the treatment of periodontitis by regulating the… DOI:10.1039/d2nr06452a | 2023 | this review only | not stated | not extracted yet |
| Huangfu 2023 Facile engineering of resveratrol nanoparticles loaded with 20(S)-protopanaxadiol for the treatment of periodontitis by regulating the… PMID:37060139 | 2023 | this review only | not stated | not extracted yet |
| Hussein 2024 Evaluation of the Effect of Topically Applied Resveratrol Gel as Adjunctive Treatment for Periodontitis DOI:10.1055/s-0044-1795084 | 2024 | this review only | Probing pocket depth (mm); Clinical attachment level (mm) | not extracted yet |
| Ikeda 2018 Resveratrol derivative‐rich melinjo seed extract induces healing in a murine model of established periodontitis DOI:10.1002/jper.17-0352 | 2018 | this review only | not stated | not extracted yet |
| Ikeda 2018 Resveratrol derivative-rich melinjo seed extract induces healing in a murine model of established periodontitis. PMID:29856488 | 2018 | this review only | IL-1β mRNA relative expression in gingiva; TNF-α mRNA relative expression in gingiva; IL-6 mRNA relative expression in gingiva | not extracted yet |
| Mohammed 2025 Evaluating the Efficacy of Resveratrol-Containing Mouthwash as an Adjunct Treatment for Periodontitis: A Randomized Clinical Trial DOI:10.1055/s-0044-1788686 | 2024 | this review only | not stated | not extracted yet |
| Nikniaz 2023 Impact of resveratrol supplementation on clinical parameters and inflammatory markers in patients with chronic periodontitis: a randomized… DOI:10.1186/s12903-023-02877-4 | 2023 | this review only | not stated | not extracted yet |
| Park 2013 Effects of sirtuin 1 activation on nicotine and lipopolysaccharide‐induced cytotoxicity and inflammatory cytokine production in human… DOI:10.1111/jre.12030 | 2012 | this review only | not stated | not extracted yet |
| Park 2013 Effects of sirtuin 1 activation on nicotine and lipopolysaccharide-induced cytotoxicity and inflammatory cytokine production in human… PMID:23199342 | 2013 | this review only | IL-1β protein expression; TNF-α protein expression | not extracted yet |
| Rizzo 2012 Effect of resveratrol and modulation of cytokine production on human periodontal ligament cells DOI:10.1016/j.cyto.2012.06.004 | 2012 | this review only | not stated | not extracted yet |
| Rizzo 2012 Effect of resveratrol and modulation of cytokine production on human periodontal ligament cells. PMID:22749236 | 2012 | this review only | IL-1β protein expression; IL-6 protein expression; TNF-α protein expression; IL-8 protein expression | not extracted yet |
| Shahidi 2017 Proliferative and Anti-Inflammatory Effects of Resveratrol and Silymarin on Human Gingival Fibroblasts: A View to the Future. PMID:29285030 | 2017 | this review only | IL-6 protein expression; IL-8 protein expression | not extracted yet |
| Shi 2021 Remodeling immune microenvironment in periodontitis using resveratrol liposomes as an antibiotic-free therapeutic strategy DOI:10.1186/s12951-021-01175-x | 2021 | this review only | not stated | not extracted yet |
| Shi 2021 Remodeling immune microenvironment in periodontitis using resveratrol liposomes as an antibiotic-free therapeutic strategy. PMID:34930286 | 2021 | this review only | IL-1β protein expression; IL-6 protein expression; TNF-α protein expression; Alveolar bone crest level (CEJ to bone crest distance, mm); IL-1β mRNA relative expression in gingiva; TNF-α mRNA relative expression in gingiva; IL-6 mRNA relative expression in gingiva | not extracted yet |
| Tamaki 2014 Resveratrol improves oxidative stress and prevents the progression of periodontitis via the activation of the Sirt1/AMPK and the… DOI:10.1016/j.freeradbiomed.2014.07.034 | 2014 | this review only | not stated | not extracted yet |
| Tamaki 2014 Resveratrol improves oxidative stress and prevents the progression of periodontitis via the activation of the Sirt1/AMPK and the… PMID:25091897 | 2014 | this review only | Alveolar bone crest level (CEJ to bone crest distance, mm); IL-1β mRNA relative expression in gingiva; TNF-α mRNA relative expression in gingiva; IL-6 mRNA relative expression in gingiva | 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 |
|---|---|---|
| Do Adjunctive Therapies with Natural Products Improve Periodontal Clinical Parameters After Non-Surgical Treatment? A Systematic Review… (2026) | 2 | 0.01 |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | In vitro: periodontal-related cells exposed to inflammatory or bacterial stimulation; in vivo: animals with experimentally induced periodontal disease; human: gingivitis or periodontitis (systemically healthy non-smokers) | Cell models (hPLC, hGF, hPBMC, macrophages; n=5); rodents with ligature or P. gingivalis induced periodontitis (n=6); 270 humans with gingivitis or periodontitis (n=5 RCTs) |
| Intervention | Resveratrol in any formulation or concentration; adjunctive resveratrol (oral, gel, spray, mouthwash) to non-surgical periodontal therapy in humans | Resveratrol, liposomal or nanoparticle resveratrol, oral capsules, gel, spray, emulgel, mouthwash |
| Comparison | Untreated, vehicle-treated or stimulated cells; healthy, untreated or vehicle-treated periodontitis animals; placebo, no gel or mouthwash, plaque removal, oral hygiene instruction or SRP alone | LPS alone; ligated untreated or placebo animals; SRP or plaque removal alone, placebo |
| Outcomes | Pro-inflammatory cytokines (IL-1β, IL-6, IL-8, TNF-α) protein and mRNA; alveolar bone loss; PPD, CAL, bleeding index, O'Leary plaque index | IL-1β, IL-6, TNF-α, IL-8 protein (in vitro); alveolar bone loss, IL-1β protein, IL-1β, TNF-α and IL-6 mRNA (in vivo); PPD, CAL, bleeding index, plaque index (RCTs) |
| Study designs | In vitro studies, in vivo experimental periodontitis studies, human RCTs; English language; conference abstracts excluded | In vitro (n=5), in vivo (n=6), RCTs (n=5; 15 publications, 16 datasets) |
| Timing | Published 2000 to 2025 | 3 weeks to 6 months in RCTs |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Yes | Yes | yes |
| 3Choice of study designs explained | No | Yes | no |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Partial Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | NR | No | no |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |