Twenty Years of Full-Mouth Disinfection: The Past, the Present and the Future

Abstract

Background:Conventional periodontal treatment, performed quadrant by quadrant in multiple visits, was re-evaluated in the early 1990s when the full-mouth disinfection concept was introduced. Over the years, several modifications to the full-mouth disinfection approach have been suggested.Objective:The purpose of this article is to review the evolution of full-mouth disinfection during the past 20 years, to specify its indications and to consider the prospects for this approach.Materials and Methods:An electronic and manual search of the literature, ending in December 2016, was performed by two independent researchers. Only pivotal studies and randomized controlled clinical trials published in the English language that evaluated a new approach to full-mouth disinfection were selected.Results:According to the studies included in our analysis (21 articles), several modified full-mouth disinfection protocols have been designed including: full-mouth treatment without chlorhexidine, the extension of hygiene methods and an increase in the duration of post-treatment chlorhexidine use, the replacement of chlorhexidine with other antiseptics, supplementation with antibiotics or probiotics, full-mouth antimicrobial photodynamic therapy and one-stage full-mouth disinfection combined with a periodontal dressing.Conclusion:Since 1995, several modifications have been suggested to improve the effectiveness of full-mouth disinfection. The majority of the studies demonstrate that the results obtained with full-mouth disinfection and its variants are equivalent to each other and to those obtained with the conventional quadrant method. Currently, the selection of this technique remains empirical and depends on the preferences of the practitioner and the patient. In the future, a patient-centered approach should be the best indication for the use of this technique.

Adjunctive subgingival application of Chlorhexidine gel in nonsurgical periodontal treatment for chronic periodontitis: a systematic review and meta-analysis

“…In recent years, CHX gel has been commonly used for FMD protocol in the treatment of periodontal disease. Considering the clinical benefit of FMD in varying degrees, FMD protocol has been conducted in a large number of studies [43][44][45][46]. In addition to full-mouth subgingival applications of CHX gel, tongue brush with CHX gel and mouthwash with CHX solution were also performed with the aim of maximum elimination of periodontal pathogens in the mouth.…”

Full-mouth treatment modalities (within 24 hours) for periodontitis in adults

“…A review article was published by the advocates of the full-mouth treatment concept (Teughels 2009), who disagreed with the results of these systematic reviews. Since then, more reviews have been published (Eberhard 2015;Fang 2016;Pockpa 2018;Suvan 2020;Zhao 2020). Our present systematic review is an update from 2015 (Eberhard 2015), and includes the most recent studies on this topic to ensure the evidence base for this important clinical question is up to date.…”

Adjunctive Subgingival application of Chlorhexidine gel in nonsurgical periodontal treatment for chronic periodontitis: A systematic review and meta-analysis

“…In recent years, CHX gel has been commonly used for FMD protocol in the treatment of periodontal disease. Considering the clinical benefit of FMD in varying degrees, FMD protocol has been conducted in a large number of studies [43][44][45][46] . In addition to full-mouth subgingival applications of CHX gel, tongue brush with CHX gel and mouthwash with CHX solution were also performed with the aim of maximum elimination of periodontal pathogens in the mouth.…”