Efficacy of adjunctive periodontal interventions in non-surgical periodontal therapy for Stage III/IV Grade C periodontitis: A systematic review and network meta-analysis
This study evaluates the effectiveness of adjunctive therapies combined with non-surgical periodontal treatment for Stage III/IV Grade C periodontitis, focusing on pocket depth (PD) reduction, clinical attachment level (CAL) gain, and adverse events. A systematic review and network meta-analysis wer...
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Elsevier
2025-12-01
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| Series: | Japanese Dental Science Review |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1882761625000134 |
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| author | Shih-Ying Lin Hung-Ying Lin Jui-Sheng Sun Jenny Zwei-Chieng Chang |
| author_facet | Shih-Ying Lin Hung-Ying Lin Jui-Sheng Sun Jenny Zwei-Chieng Chang |
| author_sort | Shih-Ying Lin |
| collection | DOAJ |
| description | This study evaluates the effectiveness of adjunctive therapies combined with non-surgical periodontal treatment for Stage III/IV Grade C periodontitis, focusing on pocket depth (PD) reduction, clinical attachment level (CAL) gain, and adverse events. A systematic review and network meta-analysis were conducted, including randomized controlled trials up to September 2024. Inconsistencies and publication bias were detected, prompting sensitivity analyses and effectiveness rankings of adjunctive therapies. Data from 50 studies were included, with 45 entered into network meta-analysis, covering 24 interventions and 1431 patients. Compared to scaling and root planing (SRP) alone, adjunctive systemic lincosamides with nitroimidazole (Mac/Linc+Nitro-S) demonstrated the greatest PD reduction, followed by local statins (Statins-L) in the short term (≤3 months). Statins-L also provided the highest CAL gain. In the medium term (4–6 months), Statins-L remained the most effective, followed by bisphosphonates. For long-term (>6 months) follow-up, where fewer treatment approaches were available, Nitro-S achieved the most significant PD reduction and CAL gain, followed by Mac/Linc-S. Adverse effects were mild and self-limiting. Despite promising findings, inconsistencies in CAL outcomes and potential publication bias highlight the need for further research to confirm long-term safety and efficacy. |
| format | Article |
| id | doaj-art-e40ff4e70ee54ad39c126842e271ea26 |
| institution | DOAJ |
| issn | 1882-7616 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Japanese Dental Science Review |
| spelling | doaj-art-e40ff4e70ee54ad39c126842e271ea262025-08-20T03:12:27ZengElsevierJapanese Dental Science Review1882-76162025-12-016116718710.1016/j.jdsr.2025.07.001Efficacy of adjunctive periodontal interventions in non-surgical periodontal therapy for Stage III/IV Grade C periodontitis: A systematic review and network meta-analysisShih-Ying Lin0Hung-Ying Lin1Jui-Sheng Sun2Jenny Zwei-Chieng Chang3Department of dentistry, MacKay Memorial Hospital, Taipei, Taiwan; School of Dentistry, College of Medicine, National Taiwan University, Taipei, TaiwanDepartment of Dentistry, National Taiwan University Hospital, Taipei, TaiwanDepartment of Orthopedic Surgery, Landseed International Hospital, Taoyuan, Taiwan; Department of Orthopedic Surgery, National Taiwan University Hospital, Taipei, Taiwan; Correspondence to: Department of Orthopedic Surgery, Landseed International Hospital No. 77, Guangtai Road, Pingzhen District, Taoyuan 324609, Taiwan.School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan; Correspondence to: Department of Dentistry, National Taiwan University Hospital, No. 1, Chang-De Street, Taipei 10048, Taiwan.This study evaluates the effectiveness of adjunctive therapies combined with non-surgical periodontal treatment for Stage III/IV Grade C periodontitis, focusing on pocket depth (PD) reduction, clinical attachment level (CAL) gain, and adverse events. A systematic review and network meta-analysis were conducted, including randomized controlled trials up to September 2024. Inconsistencies and publication bias were detected, prompting sensitivity analyses and effectiveness rankings of adjunctive therapies. Data from 50 studies were included, with 45 entered into network meta-analysis, covering 24 interventions and 1431 patients. Compared to scaling and root planing (SRP) alone, adjunctive systemic lincosamides with nitroimidazole (Mac/Linc+Nitro-S) demonstrated the greatest PD reduction, followed by local statins (Statins-L) in the short term (≤3 months). Statins-L also provided the highest CAL gain. In the medium term (4–6 months), Statins-L remained the most effective, followed by bisphosphonates. For long-term (>6 months) follow-up, where fewer treatment approaches were available, Nitro-S achieved the most significant PD reduction and CAL gain, followed by Mac/Linc-S. Adverse effects were mild and self-limiting. Despite promising findings, inconsistencies in CAL outcomes and potential publication bias highlight the need for further research to confirm long-term safety and efficacy.http://www.sciencedirect.com/science/article/pii/S1882761625000134Aggressive periodontitisStage III/IV Grade CNon-surgical periodontal therapyAdjunctive periodontal treatmentMeta-analysis |
| spellingShingle | Shih-Ying Lin Hung-Ying Lin Jui-Sheng Sun Jenny Zwei-Chieng Chang Efficacy of adjunctive periodontal interventions in non-surgical periodontal therapy for Stage III/IV Grade C periodontitis: A systematic review and network meta-analysis Japanese Dental Science Review Aggressive periodontitis Stage III/IV Grade C Non-surgical periodontal therapy Adjunctive periodontal treatment Meta-analysis |
| title | Efficacy of adjunctive periodontal interventions in non-surgical periodontal therapy for Stage III/IV Grade C periodontitis: A systematic review and network meta-analysis |
| title_full | Efficacy of adjunctive periodontal interventions in non-surgical periodontal therapy for Stage III/IV Grade C periodontitis: A systematic review and network meta-analysis |
| title_fullStr | Efficacy of adjunctive periodontal interventions in non-surgical periodontal therapy for Stage III/IV Grade C periodontitis: A systematic review and network meta-analysis |
| title_full_unstemmed | Efficacy of adjunctive periodontal interventions in non-surgical periodontal therapy for Stage III/IV Grade C periodontitis: A systematic review and network meta-analysis |
| title_short | Efficacy of adjunctive periodontal interventions in non-surgical periodontal therapy for Stage III/IV Grade C periodontitis: A systematic review and network meta-analysis |
| title_sort | efficacy of adjunctive periodontal interventions in non surgical periodontal therapy for stage iii iv grade c periodontitis a systematic review and network meta analysis |
| topic | Aggressive periodontitis Stage III/IV Grade C Non-surgical periodontal therapy Adjunctive periodontal treatment Meta-analysis |
| url | http://www.sciencedirect.com/science/article/pii/S1882761625000134 |
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