Full-mouth treatment concepts for chronic periodontitis: a systematic review.
OBJECTIVE
To systematically review the effectiveness of full-mouth treatment concepts for chronic periodontitis.


METHODS
A search was conducted for randomized, controlled clinical trials including full-mouth scaling with (FMD) or without (FMS) the use of antiseptics and quadrant scaling (control). Data sources included COHG, CENTRAL, MEDLINE and EMBASE. Reviewers independently conducted data abstraction and quality assessment. The primary outcome was tooth loss; secondary outcomes were the reductions of PPD and BOP and a gain of CAL.


RESULTS
Of 216 identified abstracts, seven trials were included. Meta-analysis revealed a weighted mean difference (WMD) for the reduction of PPD between FMD and control of 0.53 mm [95% confidence interval (CI) (0.28, 0.77), p<0.0001] in moderately deep pockets of single-rooted teeth. The WMD for gain in CAL was 0.33 mm [95% CI (0.04, 0.63), p=0.03] in moderately deep pockets of single- and multi-rooted teeth. Comparing FMD and FMS, the WMD for the reduction of CAL amounted to 0.74 mm [95% CI (0.17, 1.31), p=0.01] in deep pockets of multi-rooted teeth in favour of FMS. For BOP a WMD -18.0% [95% CI (-34.30, -1.70), p=0.03] was calculated in deep pockets of single-rooted teeth in favour of FMD.


CONCLUSIONS
In adults with chronic periodontitis only minor differences in treatment effects were observed between the treatment strategies.
Eberhard
Jörg
J
Department of Operative Dentistry and Periodontology, University Hospital Schleswig-Holstein, Kiel, Germany. eberhard@konspar.uni-kiel.de
Jervøe-Storm
Pia-Merete
PM
Needleman
Ian
I
Worthington
Helen
H
Jepsen
Søren
S
D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D002908:Chronic Disease; D012534:Dental Scaling / Q000379:methods*; D004846:Epithelial Attachment / Q000033:anatomy & histology; D005881:Gingiva / Q000033:anatomy & histology; D005888:Gingival Pocket / Q000628:therapy; D006801:Humans; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000628:therapy; D010518:Periodontitis / Q000628:therapy*; D012720:Severity of Illness Index; D016388:Tooth Loss / Q000517:prevention & control*; D016896:Treatment Outcome
D000891:Anti-Infective Agents, Local