Table 3. Characteristics of the included studies: non-surgical periodontal therapy.

Study	Participants	PD definition	Methods	Outcomes	Conclusion
Lafaurie and colleagues, 2007 [18]	42 patients, 25 males and 17 females, mean age 38,15 years, submitted to periodontal treatment	PD was defined as at least 10 pockets with PPD≥7 mm requiring periodontal surgery after SRP	BS was collected before and after SRP (immediately, 15 min, 30 min) and were analyzed via blood culture bottles (anaerobic)	Microorganisms growing under anaerobic conditions were identified in the peripheric blood after SRP in 80.9% (34/42) patients. Evaluation times: T1 - 2,4% (1/42) patients T2 - 73.8% (31/42) patients, T3 - 38% (16/42) patients, T4 - 19% (8/42) patients, Frequent MO P. gingivalis, and M. micros in peripheral blood	“Scaling and root planning induced bacteremia associated with anaerobic bacteria, especially in patients with periodontal disease”
Maestre and colleagues, 2008 [20]	13 patients, 8 males and 5 females, mean age 58.6 years submitted to periodontal treatment	PD was defined as PPD≥4 mm.	BS was collected before and after SRP (1 min) and were analyzed via blood culture bottles (aerobic/anaerobic)	Baseline: 0% (0/13) After treatment 76.9% (10/13) Predominate anaerobic bacteria of the genus Prevotella, followed M. micros and F. nucleatum.	“Periodontal procedures induce bacteremia and may represent risk of developing systemic complications. The use of antibiotic prophylaxis is crucial for its prevention”.
Padilla and colleagues, 2007 [21]	24 patients, 14 males and 10 females, mean age 63,5 years submitted to periodontal treatment	PD was defined as CAL≥5 mm.	BS was collected before and after (5 min.) SRP. Via blood culture bottles (anaerobics)	Baseline 0%. After treatment 29,1% (7/12) of patients with and without atherosclerosis. The most prevalent bacteria in both groups was A. actinomycetemcomitans	“Bacteremia occurred in 7/24 patients after SRP. In 4 patients, the same species found in periodontic pockets and blood cultures were selected in atherosclerotic plaques obtained one week after the dental procedure”
Forner and colleagues, 2006 [17]	60 patients (20 with periodontitis), 5 males and 15 females, mean age 43,75 years submitted to periodontal treatment	PD was defined as at least 10 sites with PPD>5 mm.	BS was collected before and after (0.5, 10, and 30 min.) SRP. Via lysis filtration (aerobic/anaerobic)	Baseline 0%, 0,5 min: 75% (15/20), 10 min 35% (7/20) , 30 min: 10% (2/20). The isolated bacteria represented a larger variety of species reflecting the increased complexity of the microflora of periodontal pocket	“Patients with periodontitis as compared with healthy individuals and gingivitis patients are at increased risk of experiencing bacteremia in association with scaling” .
Kinane and colleagues, 2006 [16]	30 patients, 18 male and 12 female, mean age 42,3 years submitted to periodontal treatmet	Periodontal disease was defined as having all quadrants with at least one pocket >6 mm, and ≥20 teeth	BS was collected before and after (immediately) via blood culture bottles (aerobic/anaerobic) and PCR assay.	Baseline: Culture methods: Baseline - 3% (1/30), SRP - 13% (4/30), PCR analysis Baseline: 13% (4/30), SRP 23% (7/30)	“Detectable dental bacteremias induced by periodontal procedures are at a lower level than previously reported
Zhang and colleagues, 2013 [55]	30 patients, 12 males and 18 females, mean age 47 (±9,5) years submitted to periodontal treatment	Periodontal disease was defined as having at list one quadrant (qualified quadrant) with a minimum of five teeth with probing depths ≥5 mm not at the same tooth.	BS was collected before, five minutes 30 seconds and 10 min after periodontal treatment and plated onto chromogenic agar, chocolate agar, and brain heart infusion agar supplemented with vitamin K plates. Any grow was subcultured and identified to at least genus level.	Culture methods: Baseline - 3% (1/30), SRP - 13% (4/30), PCR analysis: Baseline: 13% (4/30), SRP 23% (7/30)	“Detectable dental bacteremias induced by periodontal procedures are at a lower level than previously reported”

SRP – scaling and root planning, PPD Periodontal probing depth, CAL -clinical attachment level, PD – periodontal disease, MO – microorganisms; BS – blood sample; mm – millimeters; PCR – polymerase chain reaction

Lafaurie [18] - University-based (Colombia) This study was supported by the Instituto Colombiano para la Ciencia y la Tecnologia Francisco Jose de Caldas; Maestre Vera [20] - University-based (Spain); Padilla [21] -University-based (Chile); Forner [17] - University-based (Denmark) This study was supported by the Danish Dental Association, Colgate–Palmolive and the Danish Foundation for Mutual Efforts in Dental Care; Kinane [16] - University- based (United Kingdom), Zhang [55] – University-based (Australia).