A SYSTEMATIC REVIEW ON THE IMPACT OF FULL-MOUTH DISINFECTION VERSUS CONVENTIONAL STAGED SCALING AND ROOT PLANING ON CLINICAL PARAMETERS AND PATIENT-REPORTED OUTCOMES

ARWA AL HUGAIL, SARAH AL-MOTLAG, SUHA ALGHAMDI, SAJA ALJUMAH, BASHAER MAHNASHI, NAFLAH ALDOSSARI, AESHAH SHAYA, EMAN ALQAHTANI, MARYAM BOALI

Background: Periodontitis is a chronic inflammatory disease with a high global prevalence, affecting over a billion individuals worldwide. Conventional staged scaling and root planing (SRP), the established standard of care, involves treating the mouth in quadrants over multiple appointments. This protracted schedule can present a substantial barrier to treatment completion, particularly in contexts with limited healthcare access and for patients facing logistical or financial challenges. Full-Mouth Disinfection (FMD), an alternative protocol that completes the entire non-surgical therapy within 24 hours, has been proposed as a promising alternative to overcome these limitations.

Objective: The primary aim of this systematic review is to compare the effectiveness of Full-Mouth Disinfection versus conventional staged scaling and root planing on primary clinical outcomes (Probing Depth reduction, Bleeding on Probing) and key secondary patient-reported outcomes (patient comfort, treatment time) for adult patients with periodontitis.

Methods: This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. A comprehensive search of electronic databases, including Medline, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL), was performed to identify relevant randomized controlled trials (RCTs). Studies were selected based on a predefined PICO framework. The primary outcomes were Probing Depth (PD) reduction and change in Bleeding on Probing (BOP). Secondary outcomes included patient comfort, assessed via a Visual Analogue Scale (VAS), and total active treatment time.

Results: A total of 15 RCTs involving 850 participants were included in the final synthesis. The analysis revealed no statistically significant or clinically meaningful differences between FMD and staged SRP for the primary clinical outcomes of PD reduction and BOP improvement. This finding aligns with conclusions from major systematic reviews, which report that any observed differences are modest and of low clinical relevance. However, a significant and consistent difference was found for secondary outcomes. FMD protocols were substantially more time-efficient, reducing the total active treatment time and number of patient visits. This efficiency may be counterbalanced by reports of higher initial post-operative discomfort and a greater incidence of minor side effects, such as transient fever, in the FMD group.

Conclusion: While Full-Mouth Disinfection offers no clear clinical superiority over conventional staged SRP in terms of periodontal parameter improvement, its condensed treatment schedule presents a significant logistical advantage. In healthcare settings where patient adherence to multi-visit protocols is a concern, FMD could be a valuable public health strategy to improve treatment completion rates and overall clinic efficiency. Future research is recommended to evaluate the cost-effectiveness, patient acceptance, and long-term outcomes of this consolidated treatment approach in various clinical and demographic settings.