Recent systematic reviews showed the use of root surface bio-modifiers provides no benefit of clinical significance to root coverage and chronic periodontitis treatments. The purpose of this systematic review is to determine whether chemical root surface biomodification improves the predictability of attaining positive clinical results following chronic periodontitis treatment or root coverage procedures. Material and Methods: The selected studies met the inclusion criteria. Mean change in clinical measurements and mean coefficient of variability for treatment outcomes were evaluated. Results: after reviewing 4996 articles, 19 articles were included in the study based on inclusion criteria. No significant differences were found between treatment groups for chemical root surface biomodification regardless of treatment type. Conclusion: The addition of chemical root surface biomodification to treatment of chronic periodontitis or root coverage procedures produced no significant change in mean clinical outcomes. Chemical root surface biomodification does not improve the predictability of periodontal surgical clinical outcomes.