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Subgingival instrumentation for treatment of periodontitis. A systematic review
Author(s) -
Suvan Jeanie,
Leira Yago,
Moreno Sancho Federico Manuel,
Graziani Filippo,
Derks Jan,
Tomasi Cristiano
Publication year - 2020
Publication title -
journal of clinical periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.456
H-Index - 151
eISSN - 1600-051X
pISSN - 0303-6979
DOI - 10.1111/jcpe.13245
Subject(s) - medicine , periodontitis , dentistry , randomized controlled trial , instrumentation (computer programming) , meta analysis , medline , gingival and periodontal pocket , surgery , computer science , operating system , political science , law
Objectives To evaluate the efficacy of subgingival instrumentation (PICOS‐1), sonic/ultrasonic/hand instruments (PICOS‐2) and different subgingival instrumentation delivery protocols (PICOS‐3) to treat periodontitis. Methods Systematic electronic search (CENTRAL/MEDLINE/EMBASE/SCOPUS/LILACS) to March 2019 was conducted to identify randomized controlled trials (RCT) reporting on subgingival instrumentation. Duplicate screening and data extraction were performed to formulate evidence tables and meta‐analysis as appropriate. Results As only one RCT addressed the efficacy of subgingival instrumentation compared with supragingival cleaning alone (PICOS‐1), baseline and final measures from 9 studies were considered. The weighted pocket depth (PD) reduction was 1.4 mm (95%CI: 1.0 1.7) at 6/8 months, and the proportion of pocket closure was estimated at 74% (95%CI: 64–85). Six RCTs compared hand and sonic/ultrasonic instruments for subgingival instrumentation (PICOS‐2). No significant differences were observed between groups by follow‐up time point or category of initial PD. Thirteen RCTs evaluated quadrant‐wise versus full‐mouth approaches (PICOS‐3). No significant differences were observed between groups irrespective of time‐points or initial PD. Five studies reported patient‐reported outcomes, reporting no differences between groups. Conclusions Nonsurgical periodontal therapy by mechanical subgingival instrumentation is an efficacious means to achieve infection control in periodontitis patients irrespective of the type of instrument or mode of delivery. Prospero ID: CRD42019124887.