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Aim 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. Methods 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). Results 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). Conclusions 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. [ABSTRACT FROM AUTHOR]

Aim The aim of this systematic review was to evaluate the efficacy of anti-plaque chemical formulations for managing gingivitis, in 6-month, home-use, randomised clinical trials ( RCTs). Material and Methods A protocol was designed, including inclusion and exclusion criteria to identify RCTs assessing gingival and/or bleeding indices. Electronic and hand-searches identified relevant papers, which were screened and evaluated for inclusion. Full-papers were retrieved and relevant information was extracted (also plaque indices), including quality and risk of bias. Mean treatment effects were calculated to obtain weighted mean differences ( WMD) and 95% confidence intervals. Results After the process of screening and selection, 87 articles with 133 comparisons, were included in the review. The additional effects of the tested products were statistically significant in terms of Löe & Silness gingival index (46 comparisons, WMD −0.217), modified gingival index ( n = 23, −0.415), gingivitis severity index ( n = 26, −14.939%) or bleeding index ( n = 23, −7.626%), with significant heterogeneity. For plaque, additional effects were found for Turesky (66 studies, WMD −0.475), Silness & Löe ( n = 26, −0.109), and plaque severity ( n = 12, −23.4%) indices, with significant heterogeneity. Conclusion Within the limitations of the present study, formulations with specific agents for chemical plaque control provide statistically significant improvements in terms of gingival, bleeding and plaque indices. [ABSTRACT FROM AUTHOR]

Aim: To answer the following PICO question: In systemically healthy humans with peri‐implant mucositis, what is the efficacy of patient‐performed or administered (by prescription) measures used adjunctively to submarginal instrumentation, as compared to submarginal instrumentation alone or combined with a negative control, in terms of reducing bleeding on probing (BOP), in randomized controlled clinical trials (RCTs) with at least 3 months of follow‐up? Materials and Methods: Three databases were searched until April 2022. Weighted mean differences (WMDs) with 95% confidence intervals (CIs) and predictive intervals were calculated. Results: Sixteen parallel RCTs corresponding to 14 studies with low/moderate risk of bias were included. Test groups showed greater reductions in BOP (%) than control groups (nstudies = 16; npatients = 650; WMD = 14.25%; 95% CI [9.06–19.45]; p <.001; I2 = 98.7%). The greatest WMD in BOP reductions (%) were obtained by antiseptics (ns = 5; np = 229; WMD = 22.72%; 95% CI [19.40–26.04]; p < 0.001; I2 = 94.8%), followed by probiotics (ns = 6; np = 260; WMD = 12.11%; 95% CI [3.20–21.03]; p =.008; I2 = 93.3%) and systemic antibiotics (ns = 3; np = 101; WMD = 5.97%; 95% CI [1.34–10.59]; p =.012; I2 = 58.1%). Disease resolution was scarcely reported (n = 6). Conclusions: Significant clinical improvements can be obtained when professional submarginal instrumentation is combined with patient‐performed or administered (by prescription) adjunctive measures, although a complete disease resolution may not be achieved. [ABSTRACT FROM AUTHOR]

Aim: To answer the following PICOS question: "In patients with peri‐implantitis, what is the efficacy of surgical therapy with adjunctive systemic or local antimicrobials, in comparison with surgical therapy alone, in terms of pocket probing depth reduction, as assessed in randomized controlled trials (RCTs) with at least 6 months of follow‐up?" Materials and Methods: A systematic literature search was conducted. Reduction in mean probing pocket depth (PPD) was the primary outcome. Secondary clinical outcomes were changes in suppuration (%), changes in bleeding on probing (BOP) (%), marginal bone level changes (mm), disease resolution (%), and implant/prosthesis loss (%). Patient‐reported outcome measures, possible adverse effects, and oral‐health‐related quality of life were also extracted if such data were available. Results: Four RCTs assessing the use of locally (two RCTs) and systemically (two RCTs) administered antimicrobial adjuncts to surgical treatment of peri‐implantitis, with 6–36‐month follow‐up, were included. Because of the substantial heterogeneity of interventions between the studies, meta‐analysis could not be performed. A reduction in the mean PPD was observed following all the involved surgical treatments, irrespective of the addition of antimicrobials. Except for the effect of systemic antimicrobials on marginal bone level changes and local antimicrobials on BOP, the effect of systemic and local antimicrobials was equivocal for all secondary outcome measures. Conclusions: Based on the limited available evidence, the adjunctive use of the currently tested systemic or local antimicrobials during surgical therapy, in comparison with surgical therapy alone, in patients with peri‐implantitis does not seem to improve the clinical efficacy. With regard the use of systemic antimicrobials, only 50% of the cases showed disease resolution after 1 year. There is a lack of studies that consider the sole use of local antimicrobials. Therefore, their true effect remains unclear. [ABSTRACT FROM AUTHOR]

Aim: To answer the following PICOS question: In adult patients with peri‐implantitis, what is the efficacy of sub‐marginal instrumentation combined with chemical surface decontamination in comparison with sub‐marginal instrumentation with or without placebo, in terms of changes in probing depth (PD) and/or bleeding on probing, as reported in prospective randomized controlled trials, non‐randomized controlled trials, or prospective cohort studies, with a minimum of 6‐month "follow‐up". Materials and Methods: A systematic literature search was performed in PubMed, Web of Science, Embase, Scopus, Ovid Medline, and The Cochrane Library of the Cochrane Collaboration (CENTRAL) for articles published until March 2022. Data addressing the primary and secondary outcomes were extracted. Results: The search gave 2033 results of which 3 fulfilled the inclusion criteria. Two studies investigated the use of anti‐microbial photodynamic therapy as adjunct to sub‐marginal instrumentation and the third study assessed the adjunctive use of a desiccant material. A meta‐analysis was not deemed meaningful because of the large heterogeneity among the studies. All three studies showed favourable results in terms of PD reduction for chemical surface decontamination over control approaches, but were inconsistent or showed no differences for the other outcome variables. Conclusions: Adjunctive chemical approaches for implant surface decontamination may offer an advantage over sub‐marginal instrumentation alone, in terms of improved PD. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the efficacy of adjunctive therapies in reducing gingivitis and plaque by means of a systematic review of randomized clinical trials (RCTs). Material and Methods: A search protocol was designed to identify 6‐month RCTs that investigated the efficacy of adjuncts to mechanical plaque control on gingivitis and plaque. Following screening, relevant information was extracted, and quality and potential risk of bias were estimated. Mean treatment differences were calculated to obtain standardized mean differences and weighted mean differences (SMD and WMD) as appropriate. Results: Meta‐analyses included 70 studies of adjunctive antiseptics. Compared with mechanical plaque control alone, adjuncts yielded statistically significant reductions in gingival index (n = 72; SMD = −1.268; 95% CI [−1.489; −1.047]; p <.001; I2 = 96.2%), bleeding (%) (n = 26, WMD=−14.62%; 95% CI [−18.01%; −11.23%]; p <.001; I2 = 95.1%), plaque index (n = 93, SMD = −1.017; 95% CI [−1.194; −0.840]; p <.001; I2 = 95.3%) and plaque (%) (n = 23; WMD = −18.20%; 95% CI [−24.00%; −12.50%]; p <.001; I2 = 96.9%). Mouthrinses resulted in greater reductions in per cent plaque compared with dentifrices (meta‐regression, coefficient = 13.80%; 95% CI [2.40%; 25.10%]; p =.020). The antiseptic agents were similarly effective in reducing gingivitis and plaque in patients with dental plaque‐induced gingivitis (intact periodontium) or previously treated periodontitis with gingival inflammation. Conclusion: Adjunctive antiseptics in mouthrinses and dentifrices provide statistically significant reductions in gingival, bleeding and plaque indices. [ABSTRACT FROM AUTHOR]

Aim: To investigate whether the clinical benefits obtained with a periodontal prevention programme in subjects with periodontal health or minimal disease were accompanied by beneficial changes in the subgingival microbiota. Material and Methods: One hundred and twenty-four subjects completed the study. Subjects were clinically and microbiologically monitored at baseline, 1, 2 and 3 years. Subgingival plaque samples were taken from the mesiobuccal aspect of every tooth and were analysed for the levels of 40 bacterial species using checkerboard DNA–DNA hybridization (total samples=13,477). The mean counts of each of the 40 test species were calculated for each subject at each time point. Significance of differences over time was sought using the Friedman test. p values were adjusted for multiple comparisons. Results: All clinical parameters, at the microbiologically sampled sites, improved over time. The clinical changes were accompanied by statistically significant decreases in the mean counts of 35 of the 40 test species. Major reductions occurred by year 2 for Actinomyces, Capnocytophaga, Campylobacter, Fusobacterium and Prevotella species. At year 3, there was a modest re-growth of the majority of the species. Conclusions: The clinical improvements obtained through preventive measures were accompanied by a shift to a more host-compatible subgingival microbiota. [ABSTRACT FROM AUTHOR]