Comparison of full‐mouth disinfection and quadrant‐wise scaling in the treatment of adult chronic periodontitis: a systematic review and meta‐analysis

Abstract

Scaling and root planing are widely considered as effective methods for treating chronic periodontitis. A meta-analysis published in 2008 showed no statistically significant differences between full-mouth disinfection (FMD) or full-mouth scaling and root planing (FMS) and quadrant scaling and root planing (Q-SRP). The FMD approach only resulted in modest additional improvements in several indices. Whether differences exist between these two approaches requires further validation. Accordingly, a study was conducted to further validate whether FMD with antiseptics or FMS without the use of antiseptics within 24 h provides greater clinical improvement than Q-SRP in patients with chronic periodontitis. Medline (via OVID), EMBASE (via OVID), PubMed and CENTRAL databases were searched up to 27 January 2015. Randomized controlled trials comparing FMD or FMS with Q-SRP after at least 3 mo were included. Meta-analysis was performed to obtain the weighted mean difference (WMD), together with the corresponding 95% confidence intervals. Thirteen articles were included in the meta-analysis. The WMD of probing pocket depth reduction was 0.25 mm (p < 0.05) for FMD vs. Q-SRP in single-rooted teeth with moderate pockets, and clinical attachment level gain in single- and multirooted teeth with moderate pockets was 0.33 mm (p < 0.05) for FMD vs. Q-SRP. Except for those, no statistically significant differences were found in the other subanalyses of FMD vs. Q-SRP, FMS vs. Q-SRP and FMD vs. FMS. Therefore, the meta-analysis results showed that FMD was better than Q-SRP for achieving probing pocket depth reduction and clinical attachment level gain in moderate pockets. Additionally, regardless of the treatment, no serious complications were observed. FMD, FMS and Q-SRP are all effective for the treatment of adult chronic periodontitis, and they do not lead to any obvious discomfort among patients. Moreover, FMD had modest additional clinical benefits over Q-SRP, so we prefer to recommend FMD as the first choice for the treatment of adult chronic periodontitis.

The clinical and systemic effects of periodontal treatment in diabetic and non-diabetic obese patients

“…The addition of FMD to FM-SRP or quadrant SRP (Q-SRP) is effective (13,14) and does not cause any obvious discomfort or change in one's quality of life (15). Moreover, based on a recent meta-analysis, FMD, FMS, and Q-SRP all effectively manage CP.…”

“…Moreover, based on a recent meta-analysis, FMD, FMS, and Q-SRP all effectively manage CP. Comparison of FMD and Q-SRP revealed that FMD was moderately better than Q-SRP in reducing probing depth and increasing clinical attachment level (13). Therefore, we used FMD and FM-SRP as the treatment of choice to restrict the cumulative effect of bacteremia and avoid repeated acute inflammation during treatment (16,17).…”

A double‐masked Randomized Clinical Trial (RCT) comparing four periodontitis treatment strategies: 5‐year clinical results

“…The majority of these reviews indicate a small additional clinical benefit of these drugs as compared to scaling and root planing alone (Fritoli et al., ; Herrera, Alonso, León, Roldán, & Sanz, ; Jepsen & Jepsen, ; Keestra, Grosjean, Coucke, Quirynen, & Teughels, ; Kolakovic, Held, Schmidlin, & Sahrmann, ; Santos et al., ; Sgolastra, Severino, Petrucci, Gatto, & Monaco, ; Slots & Ting, ; Smiley et al., ; Zandbergen, Slot, Niederman, & Van der Weijden, ). Regarding the question of the relative benefit of one‐day full‐mouth disinfection (FDIS) approach over the traditional quadrant‐based scaling and root planing (qSRP) approach, only a few systematic reviews exist (Eberhard, Jepsen, Jervøe‐Storm, Needleman, & Worthington, , ; Fang et al., ; Farman & Joshi, ; Lang, Tan, Krähenemann, & Zwalen, ). These conclude that there is no clear evidence for a benefit of FDIS over qSRP.…”

Oral Health and Care at Intensive Care Units

“…Such procedure often required intravenous sedation, which was performed by the physician in charge. This particular procedure requires the dental surgeon to be prepared for the possible clinical needs of the patients, as well as to always respect their individuality and urgent needs in order to solve the oral issues that may and are affecting the systemic health of critically ill patients [48,49].…”