Fonseca 2015.

Study characteristics
Methods	Study design: RCT with 6‐arm parallel design (3 arms included) Recruitment period: 2011–2012 Setting: University Dental Hospital, Brazil Number of centres: 1 Funding source: Productivity Research fellows (PQ) and the National Program of Academic Cooperation (PROCAD) grant 552264/2011‐3 from National Council of Scientific and Technological Development (CNPq), Brasilia, Brazil (to FOC)
Participants	Inclusion criteria: diagnosis of chronic periodontitis Exclusion criteria: systemic disease or on antibiotics from 3 months before or during study Age: 35–60 years Sex: 52 F (grouping unknown), 33 M (grouping unknown) Smokers: 72 non‐smokers, 13 smokers, grouping unknown Number randomised: 90 (15 in each of 6 groups) Number evaluated: 85 (groups included in review – FMD: 15; FMS: 15; control: 13)
Interventions	Comparison: FMD vs control; FMS vs control; FMD vs FMS FMD group: (FC) hand instrumentation in 2 sessions within 24 hours, 60 minutes per session, for 2 consecutive days, after instrumentation: subgingival CHX 1%; tongue brushing: CHX 1%, 1 minute; rinse: CHX 0.12%, 30 seconds, last 10 seconds involving gargling, 2 × per session. Home: rinse: CHX 0.12%, 2 × day, 2 weeks FMS group: (FNC): hand instrumentation within 24 hours in 2 sessions, 60 minutes each session, for 2 consecutive days Control group: (QSNC) QRP 4 sessions, 1‐weekly intervals, hand instruments, 30 minutes for each Q Groups not used in the review: FMD using AZ; SRP plus AZ; SRP plus CHX OHI before study start: unknown Instruments used: hand instruments Time per Q: 30 minutes Maintenance: none reported Retreatment: none Duration of study: 6 months
Outcomes	Primary outcome: PPD (6 sites per tooth). PPD used for whole mouth as well as for pocket categories Secondary outcomes: CAL (6 sites per tooth), changes total bacterial counts. CAL used for whole‐mouth recordings* Teeth: whole‐mouth recordings with manual probe Pocket depth at baseline: 4 mm and 5 mm, ≥ 6 mm Outcome time reported: 3‐ and 6‐month data used. Baseline, 3 and 6 months measured Other outcomes: *changes in baseline CAL 3–4 mm and ≥ 5 mm (not used, does not correspond the PPD sites)
Notes	Quote: "The groups were homogeneous in regard to sex, age, and smoking status (P >0.05)".
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Participants were randomised into groups according to opaque envelopes.
Allocation concealment (selection bias)	Low risk	Quote: "Ninety opaque envelopes containing the groups' therapy identifications were sealed, mixed, and numbered sequentially". Envelopes "were opened by a masked researcher (LOMC)".
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Quote: "Examiners (FOC and JRC) were masked to the intervention group", "Treatment procedures were performed by four experienced periodontists (DCF, SCC, LCMC, and MVMC) masked to the adjuvant groups."
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Dropout of 2 participants in the control group before 3‐month examination for unclear reasons.
Selective reporting (reporting bias)	Low risk	Data reported on all primary and secondary outcomes.
Other bias	Unclear risk	Baseline balance good for pocket depth, however smoking unclear. No apparent other biases.