Swierkot 2009.

Methods	Study design: RCT with 3‐arm parallel design Recruitment period: Unclear Setting: University Dental Department, Marburg, Germany Number of centres: One Funding Source: Supported by University
Participants	Inclusion criteria: Diagnosis: Chronic periodontitis ‐ with PD of > 5 mm and BOP. All patients were in good general health Exclusion criteria: antibiotics from 6 months before or during study, history of systemic disease, orthodontic patients, pregnancy Age: 28 to 63 years Gender: 20 F (FMS/FMD/control 7/7/6) and 5 M (2/2/1) Smokers: 5 (3/1/1) (smoking at least 10 cigarettes per day) Number randomised: 25 (9/9/7) Number evaluated: 25 (9/9/7)
Interventions	Comparison: FMS vs control: FMD vs control: FMS vs FMD Test group 1: (FM‐SRP): 2 sessions within 24 hours Test group 2: (FMD): 2 sessions scaling within 24 hours; after instrumentation: tongue brushing: CHX = 1%, 1 min; rinse: CHX = 0.2%, twice for 1 min; spray pharynx: CHX = 0.2% 4 x each, subgingival: CHX = 1%. Home: rinse CHX = 0.2%, 1 min, 2 x day, 14 days; spray tonsils: CHX = 0.2%, 1 x day, 14 days Control group: (Q‐SRP): 4 sessions quadrant wise, 1 week interval starting first quadrant, hand and US instruments OHI before study start: Yes Instruments used: Hand and US instruments Time per Q: Unclear Maintenance: 1, 2, 4 and 8 months Retreatment: None Duration of study: 8 months
Outcomes	Primary outcome: PPD (4 sites per tooth) Secondary outcomes: CAL, BOP (4 sites per tooth). Manual probe for all measurements Teeth: Whole‐mouth recordings (baseline, 1, 2, 4, and 8 months). Data split in single‐ and multi‐rooted teeth for moderate (4 ‐ 6 mm) pockets and whole‐mouth recordings for deep ( ≥ 7 mm) pockets Pocket depth at baseline: moderate (PPD 4 ‐ 6 mm) and deep pockets (PPD > 7 mm) Outcome time reported: 4 months used. 1, 2, 4, 8 months measured. Other outcomes: PLI, API, microbiology
Notes	Blinding unclear. Exclusion of third molars, as well as teeth with furcation degree II and III
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	"The randomisation was performed with a combination of coin toss and drawing of lots by a second person not involved in the study to assign the patients into the following groups: full mouth disinfection (FMD), FM‐SRP and Q‐SRP".
Allocation concealment (selection bias)	Low risk	"The sequence was concealed until interventions were assigned".
Incomplete outcome data (attrition bias) All outcomes	Low risk	"One patient in every group was excluded from the study due to prescribed antibiotics because of sinusitis maxillaris. The patient of the FM‐SRP group dropped out 2 months after treatment and the two patients of the other two groups dropped out 4 months after treatment. Their data were not included into the statistical analysis".
Blinding of outcome assessment (detection bias) All outcomes	High risk	"The treatment and reassessment were performed by one periodontist who had been trained and tested previously for his reproducibility".
Selective reporting (reporting bias)	Low risk	Data reported on all primary and secondary outcomes.
Other bias	Low risk	Baseline balance good for pocket depth and smoking. No apparent other biases.