Abstract
Data sources Sources were Medline and the Cochrane Oral Health Group Specialist Register up to April 2001. Only English-language studies were included.
Study selection Controlled trials and longitudinal studies, with data analysed at patient level, were chosen for consideration.
Data extraction and synthesis Information about the quality and characteristics of each study was extracted independently by two reviewers. Kappa scores determined their agreement. Data were pooled when mean differences and standard errors were available using a fixed-effects model.
Results No randomised controlled trials were identified. Four out of 10 of the controlled studies found that subgingival debridement (SGD) is clinically effective. In the one study where SGD was found to not be effective, oral hygiene instruction was not provided. The weighted mean of attachment gain of SGD in pockets that were initially ⩾5 mm was 0.64 mm, compared with 0.37 mm for supragingival plaque control (SPC) only. The reduction of pocket depth was 0.59 and 1.18 mm for SPC and SGD, respectively.
Eighteen papers only provided information on the effect of treatment compared with baseline values, eight showed SGD to be beneficial with regard to clinical attachment level change, and the remaining 10 provided no such an analysis. The weighted mean of this effect was a 0.74-mm gain of attachment as a result of treatment in pockets initially ⩾4 mm.
Conclusions When people have chronic periodontitis, SGD (in conjunction with SPC) is an effective treatment in reducing probing pocket depth and improving the clinical attachment level. Further, it is more effective than SPC alone.
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Address for correspondence: Fridus Van der Weijden, Department of Periodontology, Academic Centre for Dentistry Amsterdam, ACTA, Louwesweg 1, 1066 EA Amsterdam, The Netherlands. E-mail: ga.vd.weijden@acta.nl
Van der Weijden GA, Timmerman MF. A systematic review on the clinical efficacy of subgingival debridement in the treatment of chronic periodontitis. J Clin Periodontol 2002; 29(suppl. 3): S55–S71.
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Niederman, R. Subgingival debridement is effective in treating chronic periodontitis. Evid Based Dent 4, 61 (2003). https://doi.org/10.1038/sj.ebd.6400211
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DOI: https://doi.org/10.1038/sj.ebd.6400211
