A systematic review of the effects of full-mouth debridement with and without antiseptics in patients with chronic periodontitis.
OBJECTIVE
To assess the clinical and microbiological effects of full-mouth debridement with (FMD) and without the use of antiseptics [full-mouth scaling and root planing (FMSRP)] in comparison with conventional staged debridement (CSD) in patients with chronic periodontitis after at least 6 months.


METHODS
The search in MEDLINE (PubMed), covering a period of 1975 to October 2007, and hand searching yielded 207 titles. Forty-two abstracts and 17 full-text articles were screened for inclusion.


RESULTS
Twelve articles allowed a direct comparison of FMD with CSD, FMSRP with CSD and FMD with FMSRP. Probing pocket depth reductions were significantly greater (0.2 mm) with FMD and FMSRP compared with CSD. Moreover, a modest reduction in BOP (9%) favoured FMD. Likewise, clinical attachment levels were improved by 0.2-0.4 mm in favour of FMD and FMSRP, respectively. In all comparisons, single-rooted teeth and deep pockets benefitted slightly from FMD and FMSRP. Limited differences in the changes of the subgingival microbiota were noted between the treatment modalities.


CONCLUSIONS
Despite the significant differences of modest magnitude, FMD or FMSRP do not provide clinically relevant advantages over CSD. Hence, all three treatment modalities may be recommended for debridement in the initial treatment of patients with chronic periodontitis.
Lang
Niklaus P
NP
School of Dental Medicine, University of Berne, Berne, Switzerland. nplang@dial.eunet.ch
Tan
Wah Ching
WC
Krähenmann
Michael A
MA
Zwahlen
Marcel
M
D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D055113:Chronic Periodontitis / Q000188:drug therapy / Q000628:therapy*; D003131:Combined Modality Therapy; D003646:Debridement; D012534:Dental Scaling; D005884:Gingival Hemorrhage / Q000188:drug therapy / Q000628:therapy; D006801:Humans; D017622:Periodontal Attachment Loss / Q000188:drug therapy / Q000628:therapy; D010514:Periodontal Pocket / Q000188:drug therapy / Q000628:therapy; D016745:Root Planing
D000891:Anti-Infective Agents, Local