title: Effectiveness of Subgingival Irrigation as an Adjunct to Scaling and Root Planing in the Treatment of Chronic Periodontitis: A Systematic Review.
abstract: OBJECTIVE
  Subgingival applications of various chemotherapeutic agents have been used as an adjunct to nonsurgical periodontal treatment and preventive periodontal therapy. Their use in regular clinical practice, however, is less, perhaps due to concerns about clinical success or probably due to a lack of knowledge of their effectiveness or cost. The aim of this systematic review is to obtain overall quantitative estimate of effectiveness of subgingival irrigation (SI) in the treatment of chronic periodontitis.
  
  
  METHODS
  A literature search of electronic database was performed for articles published through December 31, 2014, followed by manual search of dental journals. Randomized controlled trails (RCTs) assessing the effect of SI as an adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis evaluated by changes in the clinical and microbiological outcomes were included.
  
  
  RESULTS
  This literature search yielded only two randomized, placebo-controlled studies that evaluated the efficacy of SI as an adjunct to SRP in patients with chronic periodontitis. The studies were methodologically not perfect (in terms of mediocre quality) with a risk of bias to come to any final conclusions to be reached. These studies didn't clearly mention about randomization, allocation concealment, blinding, dosage and formulation of irrigants, severity of periodontal disease, patient-centered outcomes and results data.
  
  
  CONCLUSIONS
  Due to insufficient evidence supporting the efficacy of SI as an adjunct to SRP in treating chronic periodontitis, more rigorous scientific research is required to assess the efficacy of SI as an adjunct to SRP in the treatment of periodontal diseases.
authors.affiliation: Associate Professor, Department of Periodontics, Narayana Dental College & Hospital , Chinthareddypalem, Nellore, Andhra Pradesh, India .
authors.forename: Sreenivas
authors.initials: S
authors.lastname: Nagarakanti
authors.affiliation: Senior Lecturer, Department of Periodontics, Narayana Dental College & Hospital , Chinthareddypalem, Nellore, Andhra Pradesh, India .
authors.forename: Sumanth
authors.initials: S
authors.lastname: Gunupati
authors.affiliation: Professor & Head, Department of Periodontics, Narayana Dental College & Hospital , Chinthareddypalem, Nellore, Andhra Pradesh, India .
authors.forename: Vijay Kumar
authors.initials: VK
authors.lastname: Chava
authors.affiliation: Professor, Department of Periodontics, Narayana Dental College & Hospital , Chinthareddypalem, Nellore, Andhra Pradesh, India .
authors.forename: Bhumanapalli Venkata Ramesh
authors.initials: BV
authors.lastname: Reddy
keywords: Gingival inflammation; Periodontal pocket; periodontal diseases