Mongardini 1999.

Study characteristics
Methods	Study design: RCT with 2‐arm parallel design Recruitment period: unclear Setting: university dental hospital, Belgium Number of centres: 1 Funding source: supported by university
Participants	Inclusion criteria: diagnosis of chronic periodontitis with PD ≥ 7 mm and BOP (people with aggressive periodontitis also included). All participants in good general health Exclusion criteria: antibiotics from 4 months before or during study, smokers Age: 23–69 years (based on all 40) Sex: 9 F (FMD: 7; control: 2), 15 M (FMD: 5; control 10) Smokers: 8 (FMD: 3; control: 5) (smoking ≥ 10 cigarettes per day) Number randomised: 24 (40 including aggressive periodontitis) Number evaluated: 24 (12 per group)
Interventions	Comparison: FMD vs control* FMD group: 2 sessions within 24 hours, after instrumentation; tongue brushing: CHX 1%, 1 minute; rinse: CHX 0.2%, 1 minute; spray pharynx: CHX 0.2%; subgingival: CHX 1%, 3 times within 10 minutes, repeat subgingival after 8 days. Home: rinse CHX 0.2%, 1 minute, 2 × day, 2 months; spray: CHX 0.2%, 2 × day, 2 months Control group: SRP 4 sessions 2‐weekly intervals OHI before study start: no Instruments used: hand instruments Time per Q: unclear Maintenance: after 1, 2 and 4 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: only recording of first Q. Data split in single‐/multi‐rooted teeth and initial moderate (PPD 4.5–6.5 mm) and deep pockets (PPD ≥ 7 mm) Pocket depth at baseline: moderate (PPD 4.5–6.5 mm) and deep pockets (PPD ≥ 7 mm) Outcome time reported: 4 and 8 months used, 1, 2, 4 and 8 months measured Other outcomes: SBI, plaque extent, pain and swelling on VAS, number of analgesics, occurrence of herpes labialis or oral ulcers
Notes	Only data from participants with chronic periodontitis were included in the meta‐analysis. *The follow‐up paper Quirynen 2000 involved a third group that was not randomised.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Quote: "…the participants signed an informed consent form and were randomly distributed between test and control groups by coin toss…".
Allocation concealment (selection bias)	Unclear risk	Unclear.
Blinding of outcome assessment (detection bias) All outcomes	High risk	The same person (CM) performed treatment and examination. Quote: "The sessions of scaling and root planing (SRP) were performed under local anaesthesia by the same investigator (CM)…" "…clinical parameters…were recorded by the same periodontist (CM)".
Incomplete outcome data (attrition bias) All outcomes	Low risk	All participants completed study.
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.