Seven RCTs were included in the meta-analysis (n=254 patients). Sample size ranged from 10 to 71 patients. Follow-up ranged from six to eight months. Three studies were considered low risk of bias, two studies moderate risk of bias and two were high risk of bias.
Full-mouth disinfection versus quadrant scaling and root planing (four studies): Meta-analysis was not performed. Full-mouth disinfection with chlorhexidine (three studies) was associated with a statistically significant reduction in probing depth for deep pockets (≥7mm) (one study), probing pocket depth for deep and moderate pockets (two studies), bleeding on probing (one study) and statistically significant clinical attachment gain (two studies). Full-mouth disinfection using povidone-iodine (one study) showed a statistically significant increase in the number of closed pockets (<5mm) compared to quadrant scaling and root planing.
Full-mouth disinfection versus full mouth debridement (three studies): Meta-analysis was not performed. All studies showed no statistically significant difference in clinical outcome measures between full-mouth disinfection compared with full-mouth debridement.
Full-mouth debridement versus quadrant scaling and root planing (three studies): Meta-analysis (three studies) showed that there was no significant difference in reduction of initially deep pockets (≥7mm) (mean difference 0.06mm, 95% CI -0.30 to 0.41) or of initially moderate pockets (5mm to 7mm) (mean difference 0.00mm, 95% CI -0.21 to 0.21) between full-mouth debridement and quadrant scaling and root planing. There was no significant difference in probing attachment level for initially deep pockets (mean difference 0.13mm, 95% CI -0.29 to 0.56) and of initially moderate pockets (mean difference 0.11mm, 95% CI -0.11 to 0.33) between full-mouth debridement and quadrant scaling and root planing. There was no significant difference in reduction of bleeding on probing. There was no evidence of statistically significant heterogeneity.
Patient complications: Two studies showed that higher levels of pain were experienced in the full-mouth group compared to the quadrant group. Two studies showed that a higher temperature was abusive in the full-mouth group. However, two further studies found no difference in pain or body temperature between the two groups.