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Improving Scaling And Root Planing Over The Past 40 Years: A Meta-Analysis

Zaugg B,Sahrmann P,Roos M,Attin T,Schmidlin PR*

Aim: To screen whether or not classical non-surgical periodontal therapy improved over the last four decades and how adjunctive local or systemic measures influenced its clinical outcome.
Methodology: Starting from the year 1970, the entire annual sets of publications of every 5th year of the “Journal of Clinical Periodontology” and the “Journal of Periodontology” were hand searched for articles dealing with nonsurgical periodontal therapy, i.e. scaling and root planing either alone (SRP) or in combination with adjunctive local (SRPloc) or systemic (SRPsyst) treatment. Mean pocket reduction was computed for each of the three treatment modalities. Where applicable, a meta-analysis and a meta-regression as well as linear regression were performed.
Results: A total of 52 articles were found. Twenty-six thereof were randomized clinical trials. The meta-analysis revealed a standardized mean difference of pocket reduction of 0.77 mm (95% CI=0.283; 1.255) and 0.90 mm (95% CI 0.210; 1.593 for SRPloc–SRP and SRPsyst–SRP, respectively (P<0.0001). Meta regression showed significantly more mean pocket reduction for SRPloc (p=0.011) and SRPsyst (p=0.001) than for SRP. In addition, a negative correlation between time to re-evaluation and mean pocket reduction could be found (p=0.015). None of the treatment modalities improved over the past 40 years.
Conclusion: Adjunctive local or systemic measures seem to improve the classic non-surgical periodontitis therapy, i.e. scaling and root planing. None of the three analyzed treatment modalities improved over the past 40 years.