Scolaris Content Display Scolaris Content Display

支持性牙周治疗(SPT)用于维持接受牙周炎治疗的成人牙列

Appendices

Appendix 1. Cochrane Oral Health's Trials Register search strategy

From February 2013, searches of the Cochrane Oral Health Trials Register for this review were undertaken using the Cochrane Register of Studies and the search strategy below:

#1 ((periodont* or gingiva* or gingivi*)) AND (INREGISTER)
#2 ((check‐up* or "check up*" or inspect* or "dental exam*" or attend* or recall* or visit* or radiograph* or xray* or x‐ray* or scaling or scale* or curettage or plane* or planing or debride* or instuct* or advise* or educat* or teach* or train* or "oral hygiene*" or "mouth care" or "dental care" or "mouth hygiene" or "dental hygiene" or "plaque control" or antibiotic or anti‐biotic or antiseptic or anti‐septic or antibacterial or anti‐bacterial or antimicrobial or anti‐microbial or tetracycline or chlorhexidine or doxycycline or metronidazole or minocycline or roxithromycin or moxifloxacin or ciprofloxacin)) AND (INREGISTER)
#3 ((SPT or "supportive periodontal therapy")) AND (INREGISTER)
#4 ((periodont* and maintain*)) AND (INREGISTER)
#5 ((periodont* and mainten*)) AND (INREGISTER)
#6 ((posttreat or post‐treat or "preventive maintenance" or "supportive periodontal care" or "recall maintenance")) AND (INREGISTER)
#7 (#3 or #4 or #5 or #6) AND (INREGISTER)
#8 (#1 and #2 and #7) AND (INREGISTER)

Previous searches of the Oral Health Group Trials Register were undertaken using the Procite software and the search strategy below:

((periodont* or gingiva* or gingivi*) AND (check‐up* or "check up*" or inspect* or "dental exam*" or attend* or recall* or visit* or radiograph* or xray* or x‐ray* or scaling or scale* or curettage or plane* or planing or debride* or instuct* or advise* or educat* or teach* or train* or "oral hygiene*" or "mouth care" or "dental care" or "mouth hygiene" or "dental hygiene" or "plaque control" or antibiotic or anti‐biotic or antiseptic or anti‐septic or antibacterial or anti‐bacterial or antimicrobial or anti‐microbial or tetracycline or chlorhexidine or doxycycline or metronidazole or minocycline or roxithromycin or moxifloxacin or ciprofloxacin) AND (SPT or "supportive periodontal therapy" or (periodont* and maintain*) or (periodont* and mainten*) or posttreat or post‐treat or "preventive maintenance" or "supportive periodontal care" or "recall maintenance"))

Appendix 2. Cochrane Central Register of Controlled Trials (CENTRAL) search strategy

#1 MeSH descriptor Periodontal Diseases explode all trees
#2 periodonti* in All Text
#3 (gingiva* in All Text near/3 pocket* in All Text)
#4 (periodontal in All Text near/3 pocket* in All Text)
#5 "periodont* attachment loss" in All Text
#6 ((blood in All Text near/4 prob* in All Text) or (bleed* in All Text near/4 prob* in All Text))
#7 (#1 or #2 or #3 or #4 or #5 or #6)
#8 MeSH descriptor Diagnosis, Oral explode all trees
#9 ((dental in All Text near/4 check‐up* in All Text) or (dental in All Text near/4 "check up*" in All Text) or (dental in All Text near/4 inspect* in All Text) or (dental in All Text near/4 exam* in All Text) or (dental in All Text near/4 attend* in All Text) or (dental in All Text near/4 recall* in All Text) or (dental in All Text near/4 visit* in All Text) or (dental in All Text near/4 diagnos* in All Text) or (oral in All Text near/4 check‐up* in All Text) or (oral in All Text near/4 "check up*" in All Text) or (oral in All Text near/4 inspect* in All Text) or (oral in All Text near/4 exam* in All Text) or (oral in All Text near/4 attend* in All Text) or (oral in All Text near/4 recall* in All Text) or (oral in All Text near/4 diagnos* in All Text) or (tooth in All Text near/4 check‐up* in All Text) or (tooth in All Text near/4 "check up*" in All Text) or (tooth in All Text near/4 inspect* in All Text) or (tooth in All Text near/4 exam* in All Text) or (tooth in All Text near/4 attend* in All Text) or (tooth in All Text near/4 recall* in All Text) or (tooth in All Text near/4 diagnos* in All Text) or (teeth in All Text near/4 check‐up* in All Text) or (teeth in All Text near/4 "check up*" in All Text) or (teeth in All Text near/4 inspect* in All Text) or (teeth in All Text near/4 exam* in All Text) or (teeth in All Text near/4 attend* in All Text) or (teeth in All Text near/4 recall* in All Text) or (teeth in All Text near/4 diagnos* in All Text))
#10 ((dental in All Text or oral in All Text or teeth in All Text or tooth in All Text) and (radiograph* in All Text or x‐ray in All Text or xray in All Text))
#11 MeSH descriptor Dental Prophylaxis explode all trees
#12 ((dental in All Text or oral in All Text or teeth in All Text or tooth in All Text or supragingival in All Text or subgingival in All Text) and (scaling in All Text or scale* in All Text or curettage in All Text))
#13 ("dental prophylaxis" in All Text or "oral prophylaxis" in All Text)
#14 (root* next plane* in All Text or root* next planing in All Text)
#15 periodontal next debridement* in All Text
#16 MeSH descriptor Oral hygiene explode all trees
#17 MeSH descriptor Health education, dental explode all trees
#18 ((health in All Text near/5 promot* in All Text) and (dental in All Text or teeth in All Text or mouth in All Text or periodont* in All Text or gingival in All Text or oral in All Text))
#19 ((instruct* in All Text or advis* in All Text or advice* in All Text or educat* in All Text or teach* in All Text or train* in All Text) and (dental in All Text or teeth in All Text or mouth in All Text or periodont* in All Text or gingival in All Text or oral in All Text))
#20 ("oral hygiene" in All Text or (mouth in All Text near/3 care in All Text) or (dental in All Text near/3 care in All Text) or (care in All Text near/3 teeth in All Text) or (mouth in All Text near/3 hygiene in All Text) or "plaque control*" in All Text)
#21 MeSH descriptor Anti‐Infective Agents, Local explode all trees
#22 (antibiotic* in Title, Abstract or Keywords or anti‐biotic* in Title, Abstract or Keywords or "anti biotic*" in Title, Abstract or Keywords or antiseptic* in Title, Abstract or Keywords or anti‐septic* in Title, Abstract or Keywords or "anti septic*" in Title, Abstract or Keywords or antibacterical* in Title, Abstract or Keywords or anti‐bacterial* in Title, Abstract or Keywords or "anti bacterial*" in Title, Abstract or Keywords or antimicrobial* in Title, Abstract or Keywords or anti‐microbial* in Title, Abstract or Keywords or "anti microbial*" in Title, Abstract or Keywords)
#23 (tetracycline in All Text or chlorhexidine in All Text or doxycycline in All Text or metronidazole in All Text or minocycline in All Text or roxithromycin in All Text or moxifloxacin in All Text or ciprofloxacin in All Text)
#24 ((intraoral in All Text or intra‐oral in All Text or extraoral in All Text or extra‐oral in All Text) and (check‐up* in All Text or "check up*" in All Text or inspect* in All Text or exam* in All Text or attend* in All Text or recall* in All Text or visit* in All Text or diagnos* in All Text))
#25 (#8 or #9 or #10 or #11 or #12 or #13 or #14 or #15 or #16 or #17 or #18 or #19 or #20 or #21 or #22 or #23 or #24)
#26 MeSH descriptor Dental care explode all trees
#27 SPT in Title, Abstract or Keywords
#28 ("periodontal maintenance" in All Text or "supportive periodontal therap*" in All Text or "preventive maintenance" in All Text or "supportive periodontal care" in All Text or "recall maintenance" in All Text)
#29 ((periodont* in All Text near/4 maintain* in All Text) or (periodont* in All Text near/4 maintenance in All Text) or (periodont* in All Text near/4 post‐treat* in All Text) or (periodont* in All Text near/4 posttreat* in All Text) or (periodont* in All Text near/4 "post treat*" in All Text) or (periodont* in All Text near/4 prevent* in All Text))
#30 ((dentition in All Text near/4 maintain* in All Text) or (dentition in All Text near/4 maintenance in All Text) or (dentition in All Text near/4 post‐treat* in All Text) or (dentition in All Text near/4 posttreat* in All Text) or (dentition in All Text near/4 "post treat*" in All Text) or (dentition in All Text near/4 prevent* in All Text))
#31 ((dental in Title, Abstract or Keywords near/4 maintain* in Title, Abstract or Keywords) or (dental in Title, Abstract or Keywords near/4 maintenance in Title, Abstract or Keywords) or (dental in Title, Abstract or Keywords near/4 post‐treat* in Title, Abstract or Keywords) or (dental in Title, Abstract or Keywords near/4 posttreat* in Title, Abstract or Keywords) or (dental in Title, Abstract or Keywords near/4 "post treat*" in Title, Abstract or Keywords) or (dental in Title, Abstract or Keywords near/4 prevent* in Title, Abstract or Keywords))
#32 ((tooth in All Text near/4 maintain* in All Text) or (tooth in All Text near/4 maintenance in All Text) or (tooth in All Text near/4 post‐treat* in All Text) or (tooth in All Text near/4 posttreat* in All Text) or (tooth in All Text near/4 "post treat*" in All Text) or (tooth in All Text near/4 prevent* in All Text))
#33 ((teeth in All Text near/4 maintain* in All Text) or (teeth in All Text near/4 maintenance in All Text) or (teeth in All Text near/4 post‐treat* in All Text) or (teeth in All Text near/4 posttreat* in All Text) or (teeth in All Text near/4 "post treat*" in All Text) or (teeth in All Text near/4 prevent* in All Text))
#34 (#26 or #28 or #29 or #30 or #31 or #32 or #33)
#35 (#7 and #25 and #34)

Appendix 3. MEDLINE Ovid search strategy

1.    exp Periodontal Diseases/
2.    periodonti$.mp.
3.    (gingiva$ adj3 pocket$).mp.
4.    (periodontal adj3 pocket$).mp.
5.    "periodont$ attachment loss".mp.
6.    ((blood or bleed$) adj4 prob$).mp.
7.    (periimplantitis or peri‐implantitis or "peri implantitis").mp.
8.    or/1‐7
9.    exp Oral Diagnosis/
10.  ((dental or oral or tooth or teeth) adj3 (check‐up$ or "check up$" or inspect$ or exam$ or attend$ or recall$ or visit$ or diagnos$)).mp.
11.  ((intraoral or intra‐oral or extraoral or extra‐oral) adj4 (check‐up$ or "check up$" or inspect$ or exam$ or attend$ or recall$ or visit$ or diagnos$)).mp.
12.  ((dental or oral or teeth or tooth) adj3 (radiograph$ or x‐ray or xray)).mp.
13.  exp Dental Prophylaxis/
14.  ((dental or oral or teeth or tooth or supragingival or subgingival) adj6 (scaling or scale$ or curettage)).mp.
15.  ("dental prophylaxis" or "oral prophylaxis").mp.
16.  (root adj (plane$ or planing)).mp.
17.  (periodontal adj debridement$).mp.
18.  exp Oral hygiene/
19.  Health education, dental/
20.  ((Health adj5 promot$) and (dental or teeth or mouth or periodont$ or gingival or oral)).mp.
21.  ((instruct$ or advis$ or advice$ or educat$ or teach$ or train$) and (dental or teeth or mouth or periodont$ or gingival or oral)).mp.
22.  ("oral hygiene" or (mouth adj3 care) or (dental adj3 care) or (care adj3 teeth) or (mouth adj3 hygiene) or "plaque control$").mp.
23.  exp Anti‐infective agents/
24.  (antibiotic$ or anti‐biotic$ or "anti biotic$" or antiseptic$ or anti‐septic$ or "anti septic$" or antibacterical$ or anti‐bacterial$ or "anti bacterial$" or antimicrobial$ or anti‐microbial$ or "anti microbial$").mp.
25.  (tetracycline or chlorhexidine or doxycycline or metronidazole or minocycline or roxithromycin or moxifloxacin or ciprofloxacin).mp.
26.  or/9‐25
27.  Dental care/
28.  SPT.ti,ab.
29.  ((periodont$ or dentition or dental or tooth or teeth) adj4 (maintain$ or maintenance or post‐treat$ or posttreat$ or "post treat$" or prevent$)).mp.
30.  ("periodontal maintenance" or "supportive periodontal therap$" or "preventive maintenance" or "supportive periodontal care" or "recall maintenance").mp.
31.  or/27‐30
32.  8 and 26 and 31

This subject search was linked to the Cochrane Highly Sensitive Search Strategy (CHSSS) for identifying randomised trials in MEDLINE: sensitivity‐ maximising version (2008 revision) as referenced in Chapter 6.4.11.1 and detailed in box 6.4.c of The Cochrane Handbook for Systematic Reviews of Interventions, Version 5.1.0 [updated March 2011](Lefebvre 2011).

1. randomized controlled trial.pt.
2. controlled clinical trial.pt.
3. randomized.ab.
4. placebo.ab.
5. drug therapy.fs.
6. randomly.ab.
7. trial.ab.
8. groups.ab.
9. or/1‐8
10. exp animals/ not humans.sh.
11. 9 not 10

Appendix 4. Embase Ovid search strategy

1. exp Periodontal Diseases/
2. periodonti$.mp.
3. (gingiva$ adj3 pocket$).mp.
4. (periodontal adj3 pocket$).mp.
5. "periodont$ attachment loss".mp.
6. ((blood or bleed$) adj4 prob$).mp.
7. or/1‐6
8. exp Preventive Dentistry/
9. ((dental or oral or tooth or teeth) adj3 (check‐up$ or "check up$" or inspect$ or exam$ or attend$ or recall$ or visit$ or diagnos$)).mp.
10. ((intraoral or intra‐oral or extraoral or extra‐oral) adj4 (check‐up$ or "check up$" or inspect$ or exam$ or attend$ or recall$ or visit$ or diagnos$)).mp.
11. ((dental or oral or teeth or tooth) adj3 (radiograph$ or x‐ray or xray)).mp.
12. exp Dental Prophylaxis/
13. ((dental or oral or teeth or tooth or supragingival or subgingival) adj6 (scaling or scale$ or curettage)).mp.
14. ("dental prophylaxis" or "oral prophylaxis").mp.
15. (root adj (plane$ or planing)).mp.
16. (periodontal adj debridement$).mp.
17. exp Oral hygiene/
18. Health education, dental/
19. ((Health adj5 promot$) and (dental or teeth or mouth or periodont$ or gingival or oral)).mp.
20. ((instruct$ or advis$ or advice$ or educat$ or teach$ or train$) and (dental or teeth or mouth or periodont$ or gingival or oral)).mp.
21. ("oral hygiene" or (mouth adj3 care) or (dental adj3 care) or (care adj3 teeth) or (mouth adj3 hygiene) or "plaque control$").mp.
22. exp Anti‐infective agents/
23. (antibiotic$ or anti‐biotic$ or "anti biotic$" or antiseptic$ or anti‐septic$ or "anti septic$" or antibacterical$ or anti‐bacterial$ or "anti bacterial$" or antimicrobial$ or anti‐microbial$ or "anti microbial$").mp.
24. (tetracycline or chlorhexidine or doxycycline or metronidazole or minocycline or roxithromycin or moxifloxacin or ciprofloxacin).mp.
25. or/8‐24
26. Dental care/
27. SPT.ti,ab.
28. ((periodont$ or dentition or dental or tooth or teeth) adj4 (maintain$ or maintenance or post‐treat$ or posttreat$ or "post treat$" or prevent$)).mp.
29. ("periodontal maintenance" or "supportive periodontal therap$" or "preventive maintenance" or "supportive periodontal care" or "recall maintenance").mp.
30. or/26‐29
31. 7 and 25 and 30

The above subject search was linked to adapted version of the Cochrane Embase Project filter for identifying RCTs in EMBASE Ovid (see http://www.cochranelibrary.com/help/central‐creation‐details.html for information):

1. Randomized controlled trial/
2. Controlled clinical study/
3. Random$.ti,ab.
4. randomization/
5. intermethod comparison/
6. placebo.ti,ab.
7. (compare or compared or comparison).ti.
8. ((evaluated or evaluate or evaluating or assessed or assess) and (compare or compared or comparing or comparison)).ab.
9. (open adj label).ti,ab.
10. ((double or single or doubly or singly) adj (blind or blinded or blindly)).ti,ab
11. double blind procedure/
12. parallel group$1.ti,ab.
13. (crossover or cross over).ti,ab.
14. ((assign$ or match or matched or allocation) adj5 (alternate or group$1 or intervention$1 or patient$1 or subject$1 or participant$1)).ti,ab.
15. (assigned or allocated).ti,ab.
16. (controlled adj7 (study or design or trial)).ti,ab.
17. (volunteer or volunteers).ti,ab.
18. trial.ti.
19. or/1‐18
20. (exp animal/ or animal.hw. or nonhuman/) not (exp human/ or human cell/ or (human or humans).ti.)
21. 19 not 20

Appendix 5. US National Institutes of Health Trials Register (ClinicalTrials.gov) search strategy

Advanced search:

Condition: periodontitis
Intervention: maintenance

Condition: periodontitis
Intervention: supportive

Appendix 6. WHO International Clinical Trials Registry Platform search strategy

Advanced search:

Condition: periodontitis
Intervention: maintenance

Condition: periodontitis
Intervention: supportive

Study flow diagram
Figuras y tablas -
Figure 1

Study flow diagram

Risk of bias summary: review authors' judgements about each risk of bias item for each included study
Figuras y tablas -
Figure 2

Risk of bias summary: review authors' judgements about each risk of bias item for each included study

Comparison 1 Supportive periodontal therapy (SPT) performed by specialists versus non‐specialist clinicians, Outcome 1 Bleeding on probing (%).
Figuras y tablas -
Analysis 1.1

Comparison 1 Supportive periodontal therapy (SPT) performed by specialists versus non‐specialist clinicians, Outcome 1 Bleeding on probing (%).

Comparison 1 Supportive periodontal therapy (SPT) performed by specialists versus non‐specialist clinicians, Outcome 2 Full‐mouth mean probing depths mm (final scores).
Figuras y tablas -
Analysis 1.2

Comparison 1 Supportive periodontal therapy (SPT) performed by specialists versus non‐specialist clinicians, Outcome 2 Full‐mouth mean probing depths mm (final scores).

Comparison 2 Antimicrobial + mechanical debridement versus mechanical debridement, Outcome 1 Bleeding on probing (one site per patient).
Figuras y tablas -
Analysis 2.1

Comparison 2 Antimicrobial + mechanical debridement versus mechanical debridement, Outcome 1 Bleeding on probing (one site per patient).

Comparison 2 Antimicrobial + mechanical debridement versus mechanical debridement, Outcome 2 Clinical attachment level mm (change scores).
Figuras y tablas -
Analysis 2.2

Comparison 2 Antimicrobial + mechanical debridement versus mechanical debridement, Outcome 2 Clinical attachment level mm (change scores).

Comparison 2 Antimicrobial + mechanical debridement versus mechanical debridement, Outcome 3 Pocket depth mm (final scores).
Figuras y tablas -
Analysis 2.3

Comparison 2 Antimicrobial + mechanical debridement versus mechanical debridement, Outcome 3 Pocket depth mm (final scores).

Comparison 3 Photonics + mechanical debridement versus mechanical debridement, Outcome 1 Full‐mouth mean clinical attachment level mm (final scores).
Figuras y tablas -
Analysis 3.1

Comparison 3 Photonics + mechanical debridement versus mechanical debridement, Outcome 1 Full‐mouth mean clinical attachment level mm (final scores).

Comparison 3 Photonics + mechanical debridement versus mechanical debridement, Outcome 2 Full‐mouth mean probing depths mm (final scores).
Figuras y tablas -
Analysis 3.2

Comparison 3 Photonics + mechanical debridement versus mechanical debridement, Outcome 2 Full‐mouth mean probing depths mm (final scores).

Summary of findings for the main comparison. Supportive periodontal therapy (SPT) performed by specialists versus SPT performed by non‐specialist clinicians

Supportive periodontal therapy (SPT) performed by specialists compared with SPT performed by non‐specialist clinicians

Population: adults treated for periodontitis and receiving SPT

Settings: dental clinic

Intervention: SPT performed by general dental practitioners under specialist prescription

Comparison: SPT performed in a specialist practice

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

Number of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Non‐specialist

Specialist

Tooth loss

Not measured

Bleeding on probing (%)

at 12‐month follow‐up

Mean BoP 36.7%

Mean BoP was 7.40% higher (8.12 lower to 22.92 higher)

35 participants
(1 study)

⊕⊝⊝⊝
very lowa

Clinical attachment loss

Not measured

Adverse events

Not measured

Probing pocket depth (mm) (final scores)

at 12‐month follow‐up

Mean PPD 3.0 mm

Mean PPD was 0.20 higher (0.40 lower to 0.80 higher)

35 participants
(1 study)

⊕⊝⊝⊝
very lowa

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; MD: mean difference

GRADE Working Group grades of evidence

High quality: we are very confident that the true effect lies close to that of the estimate of the effect

Moderate quality: we are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of effect, but there is a possibility that it is substantially different

Low quality: we are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of effect, but there is a possibility that it is substantially different

Very low quality: we have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect

aSingle study at high risk of bias, small sample size and imprecision in the effect estimate ‐ downgraded three levels

Figuras y tablas -
Summary of findings for the main comparison. Supportive periodontal therapy (SPT) performed by specialists versus SPT performed by non‐specialist clinicians
Summary of findings 2. Mechanical debridement plus local antimicrobial versus mechanical debridement

Mechanical debridement plus local antimicrobial compared with debridement only

Population: adults treated for periodontitis and receiving supportive periodontal therapy

Settings: dental clinic

Intervention: minocycline or doxycycline gel plus mechanical debridement

Comparison: mechanical debridement

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

Number of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Control

Antimicrobial (minocycline)

Tooth loss

Not measured

Bleeding on probing (ratios)

at 12‐month follow‐up

OR 0.45 (0.14 to 1.52)

1 study
(50 participants)

⊕⊝⊝⊝
very lowa

Clinical attachment level (mm)

at 12‐month follow‐up

Change score 4.6 mm

Change score was 0.10 mm higher (from 0.42 lower to 0.62 higher)

1 study
(53 participants)

⊕⊕⊝⊝
lowa

Tonetti 2012 assessed the effect of adjunctive doxycycline and reported no evidence of a benefit for probing attachment level.

Pocket depth (mm)

at 12‐month follow‐up

4.3 mm

PD was 0.10 mm lower (from 0.59 lower to 0.39 higher)

1 study
(51 participants)

⊕⊕⊝⊝
lowa

Tonetti 2012 assessed the effect of adjunctive doxycycline and reported no evidence of a benefit for pocket depth reduction.

Adverse events

See comment

2 studies (251 participants)

Killeen 2016 reported no adverse events at follow‐up examinations in either study arm.

Tonetti 2012 reported that there were no serious adverse events.

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; MD: mean difference; OR: odds ratio

GRADE Working Group grades of evidence

High quality: we are very confident that the true effect lies close to that of the estimate of the effect

Moderate quality: we are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of effect, but there is a possibility that it is substantially different

Low quality: we are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of effect, but there is a possibility that it is substantially different

Very low quality: we have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect

aSingle study at high risk of bias, small sample size and serious imprecision in the effect estimate ‐ downgraded three levels

bStudy (Killeen 2016) at high risk of bias and small sample size ‐ downgraded two levels

Figuras y tablas -
Summary of findings 2. Mechanical debridement plus local antimicrobial versus mechanical debridement
Summary of findings 3. Photonics plus mechanical debridement versus mechanical debridement

Photodynamic therapy plus mechanical debridement compared with mechanical debridement

Patient or population: adults treated for periodontitis and receiving supportive periodontal therapy

Settings: dental clinic

Intervention: photodynamic therapy plus mechanical debridement

Comparison: mechanical debridement

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

Number of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Control

Experimental

Tooth loss

Not measured

Bleeding on probing

Not measured in usable way

Clinical attachment level (mm)

at 12‐month follow‐up

7.76 mm

0.97 mm lower ( from 3.51 lower to 1.57 higher)

1 study (10 participants)

⊕⊝⊝⊝
very lowa

Probing pocket depth (mm)

at 12‐month follow‐up

5.9 mm

0.09 mm lower (from 1.41 lower to 1.23 higher)

1 study (10 participants)

⊕⊝⊝⊝
very lowa

Adverse events

Not measured

The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; MD: mean difference

GRADE Working Group grades of evidence

High quality: we are very confident that the true effect lies close to that of the estimate of the effect

Moderate quality: we are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of effect, but there is a possibility that it is substantially different

Low quality: we are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of effect, but there is a possibility that it is substantially different

Very low quality: we have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect

aStudy at unclear risk of bias and very small sample size ‐ downgraded three levels

Figuras y tablas -
Summary of findings 3. Photonics plus mechanical debridement versus mechanical debridement
Comparison 1. Supportive periodontal therapy (SPT) performed by specialists versus non‐specialist clinicians

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Bleeding on probing (%) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

1.1 12 months

1

35

Mean Difference (IV, Fixed, 95% CI)

7.40 [‐8.12, 22.92]

2 Full‐mouth mean probing depths mm (final scores) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

2.1 12 months

1

35

Mean Difference (IV, Fixed, 95% CI)

0.20 [‐0.40, 0.80]

Figuras y tablas -
Comparison 1. Supportive periodontal therapy (SPT) performed by specialists versus non‐specialist clinicians
Comparison 2. Antimicrobial + mechanical debridement versus mechanical debridement

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Bleeding on probing (one site per patient) Show forest plot

1

50

Odds Ratio (M‐H, Fixed, 95% CI)

0.45 [0.14, 1.52]

2 Clinical attachment level mm (change scores) Show forest plot

1

53

Mean Difference (IV, Fixed, 95% CI)

0.10 [‐0.42, 0.62]

3 Pocket depth mm (final scores) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

3.1 12 months

1

51

Mean Difference (IV, Fixed, 95% CI)

‐0.10 [‐0.59, 0.39]

Figuras y tablas -
Comparison 2. Antimicrobial + mechanical debridement versus mechanical debridement
Comparison 3. Photonics + mechanical debridement versus mechanical debridement

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Full‐mouth mean clinical attachment level mm (final scores) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

1.1 12 months

1

10

Mean Difference (IV, Fixed, 95% CI)

‐0.97 [‐3.51, 1.57]

2 Full‐mouth mean probing depths mm (final scores) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

2.1 12 months

1

10

Mean Difference (IV, Fixed, 95% CI)

‐0.09 [‐1.41, 1.23]

Figuras y tablas -
Comparison 3. Photonics + mechanical debridement versus mechanical debridement