This review of systemic or locally delivered clarithromycin as an adjunct to non-surgical periodontal therapy included 7 small RCTs, 4 RCTS related to systemic use and 3RCTS for local application. The findings provide moderate certainty evidence suggesting locally delivered clarithromycin significantly improves treatment outcome
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This review comparing access flaps (AF) and subgingival debridement in achieving probing depth (PD) reduction in patients with periodontitis included 18 studies reported in 36 publications. While the results demonstrated a statistically significant improvement in PD reduction between AF and subgingival debridement this may not be clinically important.
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This review of the impact of smoking on clinical outcomes of non-surgical periodontal treatment included 17 cohort studies of whihc 11 were prospective. The findings suggest statistically significant smaller improvements in the smoking that non-smoking group. However, any differences are modest and my not be clinically important.
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This review of of locally delivered antimicrobials as an adjunct to scaling and root planing (SRP) for the non-surgical treatment of patients with periodontitis included 50 RCTs. While the findings indicate statistically significant benefits for probing pocket depth and clinical attachment level (CAL) at 6-9 months and for CAL at 12-60 months their clinical importance can be questioned. In addition most of the studies(47) were considered to be at high risk of bias.
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This Cochrane review of the effects of systemic antimicrobials as an adjunct to scaling and root planing (SRP) for the non-surgical treatment of patients with periodontitis identified 45 RCTs. However the evidence is of very low certainty to inform tclinicians and patients if adjunctive antibiotics are beneficial.
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Two UK primary care-based trials were included in this Cochrane review update of routine scale and polish. They provide high certainty evidence of litte or no difference between 6- & 12-monthly scale and polish for adult regular attenders without severe periodontitis.
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This large multicentre, cluster randomised controlled compared the clinical effectiveness and cost-effectiveness of theory-based, personalised oral hygiene advice or scale and polish’ with routine care in improving periodontal health in dentate adults attending general dental practice.
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Only 9 small studies were identified for this review of the prevention and treatment of periodontal disease in patients with Down’s syndrome. More high quality studies are needed to help inform clinical practice
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This update of a 2010 Cochrane review found low quality evidence that periodontal treatment involving scaling and root planing does improve glycaemic control in people with diabetes, with a mean percentage reduction in HbA1c of 0.29% at 3-4 months, but there is insufficient evidence to demonstrate that this is maintained after 4 months.
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This new systematic review from the ADA includes 72 RCTs on nonsurgical treatment approaches for chronic periodontitis. The systematic review provides the basis for a new clinical practice guideline.
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