The efficiency of periodontal endoscopy in non-surgical periodontal therapy: a systematic review and meta-analysis.

Abstract

<h4>Objective</h4>Periodontal endoscopy offers a minimally invasive method to enhance subgingival visualization, potentially improving the outcomes of periodontal therapy. This systematic review and meta-analysis aim to evaluate the current evidence in the adjunctive use of periodontal endoscopy.<h4>Methods</h4>The protocol was registered with the International Prospective Register of Systematic Reviews "PROSPERO", managed by the Center for Reviews and Dissemination, the National Institute for Health Research, University of York, UK, under registration identification number (CRD420251051901). PubMed/MEDLINE, Google Scholar, The Cochrane Library, and ProQuest databases were searched up to June 2025 for randomized clinical trials (RCTs) published in English investigating non-surgical periodontal therapy with and without the adjunctive use of periodontal endoscopy. The authors independently with consensus extracted clinical outcomes. The RoB2, the revised Cochrane risk of bias tool for RCTs, was utilized to evaluate risk of bias. Meta-analysis was performed for quantitative assessment.<h4>Results</h4>Nine RCTs were identified. The narrative results of the reported clinical outcomes were diverse. Meta-analysis revealed that periodontal endoscopy was associated with significantly less residual calculus (mean difference: -1.87%, <i>p</i> = 0.0010, I2 = 0%), significantly longer treatment time by 6.01 min (<i>P</i> < 0.00001, I2 = 0%), and greater probing depth reduction (mean difference: -0.47, <i>p</i> = 0.004, I2 = 94%).<h4>Conclusion</h4>The adjunctive use of periodontal endoscopy outperformed the conventional scaling and root planing alone in calculus removal but appears to be more time-consuming. Yet, more homogeneous RCTs are necessary to attain clear evidence on additional clinical outcomes.<h4>Systematic review registration</h4>https://www.crd.york.ac.uk/PROSPERO/view/CRD420251051901, Identifier CRD420251051901.