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Introduction to Cumulative Meta-analysis in Dentistry: Lessons Learned from Undertaking a Cumulative Meta-analysis in Periodontology

¹ Eastman Dental Institute for Oral Health Care Science, University College London, 256 Gray’s Inn Road, London, WC1X 8LD, UK;
² dsm-Forsyth Center for Evidence-Based Dentistry, The Forsyth Institute, Boston, MA, USA, and Department of Health Policy and Health Services Research, Goldman School of Dental Medicine, Boston University, Boston, MA, USA; and
³ Center for Clinical Evidence Synthesis, Tufts-New England Medical Center, Boston, MA, USA;

View larger version (13K): [in a new window]   Figure 1. Conventional and Cumulative Meta-analyses of 5 Trials of Systemic Antimicrobials as an Adjunct to Scaling and Root Planing for All/Moderate Periodontal Pockets: Difference in Mean Gain in Clinical Attachment Level and 95% CI (SRP + antimicrobial vs. SRP alone) in mm. Key to Figs.: Aug, Augmentin®; Clin, Clindamycin; Dox, Doxycyline; Met, Metronidazole; Met+Amo, Metronidazole and Amoxicillin in combination; Rod, Rodogyl® (Metronidazole and Spiramycin in combination); Spi, Spiramycin; Tet, Tetracycline; and Tet/Spi, Tetracycline or Spiramycin.

View larger version (14K): [in a new window]   Figure 2. Conventional and Cumulative Meta-analyses of 5 Trials of Systemic Antimicrobials as an Adjunct to Scaling and Root Planing for Deep Periodontal Pockets (> = 6 mm at baseline): Difference in Mean Gain in Clinical Attachment Level and 95% CI (SRP + antimicrobial vs. SRP alone) in mm (key as for Fig. 1).

View larger version (13K): [in a new window]   Figure 3. Results of Trials of Systemic Antimicrobials as an Adjunct to Scaling and Root Planing: Point Estimates of Differences in Mean Gain in Clinical Attachment Level and 95% CI Where Available (SRP + antimicrobial vs. SRP alone) in mm (key as for Fig. 1). Note: *Different antimicrobial sub-studies that share control groups. In each case, the total number of patients for the study is listed once only, to avoid double-counting the controls. ?Not reported or unclear.