title: The effect on clinical parameters of periodontal inflammation following non-surgical periodontal therapy with ultrasonics and chemotherapeutic cooling solutions: a systematic review.
abstract: To establish the added effect of a chemotherapeutic cooling solution in an ultrasonic device on clinical parameters of periodontal inflammation following non-surgical periodontal therapy.
  
  
  
  The MEDLINE-PubMed, Cochrane-CENTRAL, and the EMBASE databases were searched. Probing pocket depth (PPD) and clinical attachment level (CAL) and their changes were selected as outcome variables. Subgroup analyses were performed according to the following active ingredients: essential oils (EO), povidone-iodine (PVP), and chlorhexidine (CHX).
  
  
  
  Screening of 100 unique papers resulted in 14 eligible publications, including 16 comparisons. The meta-analysis (MA) showed that when the ultrasonic cooling solution had adjuvant chemotherapeutic properties, the difference of means (DiffM) for end value PPD-0.12 (95% CI: -0.42; 0.18) and for CAL the DiffM+-0.13 (95% CI: -0.39; 0.14). None of these were statistically significant, and the findings were supported by the overall descriptive analysis. Subgroup analysis only revealed a small effect for PVP on the difference (DiffM = -0.23, 95% CI: -0.43; -0.02) with respect to CAL (p = 0.03).
  
  
  
  The collective evidence indicates that overall, no additional effects were observed. There is a "very weak" recommendation based on the sub-analysis showing that in conjunction with PVP, a very small gain in CAL may be expected. For the use of CHX or EO, the added effect can be considered to be "zero." Therefore, the strength and direction of the recommendation emerging from this review is against their use.
authors: Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands.
authors: Marjolein
authors: M
authors: Van der Sluijs
authors: Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands.
authors: Eveline
authors: E
authors: Van der Sluijs
authors: Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands.
authors: Fridus
authors: F
authors: Van der Weijden
authors: Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands.
authors: Dagmar Else
authors: DE
authors: Slot
mesh_terms: D012534:Dental Scaling; D006801:Humans; D007249:Inflammation; D010512:Periodontal Index; D010518:Periodontitis; D011206:Povidone-Iodine; D014465:Ultrasonics
chemical_list: D011206:Povidone-Iodine
keywords: chemotherapeutic; coolant; periodontitis; subgingival debridement; systematic review; ultrasonics