Evidence map›Paper›PMID 42126682›Full record

SynthesisClinical oral investigations2026

Efficacy of subgingival irrigation with chemical agents as adjuvants to non-surgical periodontal therapy: systematic review and meta-analysis.

Marcela Iunes da Silveira, Clarissa Carvalho Martins Maciel, Melissa M Grant, Iain L C Chapple, Andrea Carvalho De Marco, Emanuel da Silva Rovai

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Clinical oral investigations, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Marcela Iunes da SilveiraInstitute of Science and Technology, Diagnostics and Surgery Department, São Paulo State University (Unesp), Sao Jose dos Campos, Brazil.
Clarissa Carvalho Martins MacielInstitute of Science and Technology, Diagnostics and Surgery Department, São Paulo State University (Unesp), Sao Jose dos Campos, Brazil.
Melissa M GrantSchool of Dentistry, Institute of Clinical Sciences, University of Birmingham and Birmingham Dental Hospital (Birmingham Community Healthcare Trust), Birmingham, UK.
Iain L C ChappleSchool of Dentistry, Institute of Clinical Sciences, University of Birmingham and Birmingham Dental Hospital (Birmingham Community Healthcare Trust), Birmingham, UK.
Andrea Carvalho De MarcoInstitute of Science and Technology, Diagnostics and Surgery Department, São Paulo State University (Unesp), Sao Jose dos Campos, Brazil.
Emanuel da Silva RovaiInstitute of Science and Technology, Diagnostics and Surgery Department, São Paulo State University (Unesp), Sao Jose dos Campos, Brazil. emanuel.rovai@unesp.br.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis systematic review aims to assess the efficacy of chemical agents (CA) in subgingival irrigation as an adjunct to non-surgical periodontal treatment (NSPT) in the treatment of periodontitis.

methodsSearch strategies were developed for MEDLINE via PubMed, Web of Science, and LILACS databases for publications up to March 2025. Risk of bias was assessed according to the RoB 2.0 tool. Random-effects meta-analyses were conducted for clinical attachment level (CAL), probing pocket depth (PPD), and bleeding on probing (BOP).

resultsFrom 1244 studies initially screened, 16 randomized clinical trials were included for qualitative and quantitative analyses. Studies assessed the effects of the following chemical agents: Povidone-iodine (PVP-I), Essential Oils (EOs); Chlorhexidine (CHX), Ozonated water (OW) and Boric Acid (BA). Overall, the meta-analysis showed that the adjunctive use of CA as subgingival irrigation did not provide additional benefit in PPD reduction, CAL gain, and BOP compared with controls (P > 0.05). Most studies raised some concerns with risk of bias, and 2 showed a high risk of bias.

conclusionAdjunctive use of chemical agents in subgingival irrigation during NSPT for periodontitis patients does not appear to provide additional benefit over NSPT alone, although evidence levels are low to very low. CLINICAL RELEVANCE: CA are frequently used as adjuncts to NSPT, despite uncertainty regarding their real clinical contribution. The findings of this study help clinicians make more evidence-based decisions and avoid unnecessary use of adjunctive subgingival irrigation strategies during periodontal treatment.

Indexed as

PeriodontitisTherapeutic IrrigationAnti-Infective Agents, LocalHumansAnti-Infective Agents, LocalChemical adjunctsDental scalingPeriodontal diseaseRoot planningSystematic reviewUltrasonics

Identifiers

PMID42126682
PMCPMC13171656

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.