{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T11:34:40Z","timestamp":1785843280118,"version":"3.56.0"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,6,2]],"date-time":"2017-06-02T00:00:00Z","timestamp":1496361600000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Ora-Pharma and Atrix Laboratories in the past","award":["R03 DE024750"],"award-info":[{"award-number":["R03 DE024750"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Clinic Periodontology"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>The recent <jats:styled-content style=\"fixed-case\">ADA<\/jats:styled-content>\u2010commissioned Clinical Practice Guideline on the nonsurgical treatment of chronic periodontitis has provided the most exhaustive library of clinical trials on scaling and root planing (<jats:styled-content style=\"fixed-case\">SRP<\/jats:styled-content>) with or without adjuncts. This network meta\u2010analysis (NMA) compared the adjuncts against each other.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>A star\u2010shaped NMA was performed based on 36 indirect comparisons of clinical attachment\u2010level (<jats:styled-content style=\"fixed-case\">CAL<\/jats:styled-content>) gains among nine adjuncts in 74 studies from the Clinical Practice Guideline.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All pairwise differences were accompanied by wide confidence intervals, and none of the adjuncts were statistically significantly superior to another. Local doxycycline hyclate and photodynamic therapy with a diode laser had the highest probabilities for ranking first and second, respectively. Publication bias was evident, with fewer than expected studies with small effects. The lack of these studies inflated the treatment effects by an estimated by 20%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Adjuncts improve <jats:styled-content style=\"fixed-case\">CAL<\/jats:styled-content> gain by about a third of a mm over 6\u201312\u00a0months compared with <jats:styled-content style=\"fixed-case\">SRP<\/jats:styled-content> alone, but no significant differences were found among the adjuncts. The patient\u2010perceived benefit of this gain is unclear because <jats:styled-content style=\"fixed-case\">CAL<\/jats:styled-content> is a physical measure made by the clinician and not a patient\u2010oriented outcome. Publication bias inflated the observed treatment effects.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jcpe.12726","type":"journal-article","created":{"date-parts":[[2017,4,3]],"date-time":"2017-04-03T20:32:55Z","timestamp":1491251575000},"page":"603-611","source":"Crossref","is-referenced-by-count":52,"title":["Network meta\u2010analysis of studies included in the Clinical Practice Guideline on the nonsurgical treatment of chronic periodontitis"],"prefix":"10.1111","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5169-7691","authenticated-orcid":false,"given":"Mike T.","family":"John","sequence":"first","affiliation":[{"name":"Department of Diagnostic and Biological Sciences School of Dentistry University of Minnesota  Minneapolis MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan S.","family":"Michalowicz","sequence":"additional","affiliation":[{"name":"University of Minnesota School of Dentistry  Minneapolis MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios A.","family":"Kotsakis","sequence":"additional","affiliation":[{"name":"Department of Periodontics School of Dentistry University of Washington  Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haitao","family":"Chu","sequence":"additional","affiliation":[{"name":"Division of Biostatistics School of Public Health University of Minnesota  Minneapolis MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,6,2]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.1981.tb02024.x"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0076654"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/1536867X1501500402"},{"key":"e_1_2_8_5_1","first-page":"339","volume-title":"Methodological issues & strategies in clinical research","author":"Cohen J.","year":"1998"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdent.2013.01.008"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0006-341X.2000.00455.x"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"e_1_2_8_9_1","first-page":"339","article-title":"Association of oral health\u2010related quality of life with periodontal status and treatment needs","volume":"14","author":"Eltas A.","year":"2016","journal-title":"Oral Health & Preventive Dentistry"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7525-8-126"},{"key":"e_1_2_8_11_1","volume-title":"Cochrane handbook for systematic reviews of interventions version 5.1.0","author":"Higgins J. 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