Meta-analysis of the effect of systemic metronidazole as an adjunct to scaling and root planing for adult periodontitis Elter J R, Lawrence H P, Offenbacher S, Beck J D Authors' objectives To assess the use of systemic metronidazole (S-MET) as an adjunct to scaling and root planing (SRP) in the treatment of adult periodontitis. Searching MEDLINE was searched from 1980 to 1995 using the following keywords: 'periodontal therapy', 'periodontitis', 'metronidazole', 'drug therapy', 'antibiotics', 'randomised controlled (control) trials' and 'controlled clinical trial'. Current issues of journals specific to periodontal research (1995 to 1996) and the bibliographies of identified papers were also examined for additional studies. Study selection Study designs of evaluations included in the review Randomised clinical trials that evaluated the effect of S-MET on humans, where the studies randomised persons, quadrants, or mouths to treatment groups. The participants were treated with metronidazole for up to 4 weeks, and had to be followed up for between 4 and 26 weeks. Specific interventions included in the review S-MET (200, 250, 400 or 500 mg, three times per day, over periods of between 5 days and 4 weeks) in combination with SRP was compared with SRP alone. Oral hygiene instruction was provided to the intervention group in two trials. Participants included in the review Adults undergoing treatment for periodontitis were included. Outcomes assessed in the review The primary outcome measures were differences in pocket depth (PD) or clinical attachment level (CAL). PD was measured by a reduction in mm depth, while CAL was measured by a gain in mm of attachment. How were decisions on the relevance of primary studies made? The authors do not state how the papers were selected for the review, or how many of the authors performed the selection. Assessment of study quality The authors did not state that they assessed validity. However, they did consider some of the more important methodological aspects, such as randomisation and blinding. Data extraction The authors do not state how the data were extracted for the review, or how many of the authors performed the data extraction. Methods of synthesis How were the studies combined? For studies measuring outcomes on the same continuous scale, a fixed-effect meta-analysis was performed according to the method described by Petitti (see Other Publications of Related Interest). Database of Abstracts of Reviews of Effects (DARE) Produced by the Centre for Reviews and Dissemination Copyright © 2017 University of York Page: 1 / 3