Long-term Outcomes of Periodontal Regenerative Procedures for the Treatment of Intrabony Periodontal Defects: A Systematic Review and Meta-analysis

Authors: Kyung Nam, Nathan E. Estrin, Jasmine Sze, Jamie Saragossi, Vincent J. Iacono and Seyed Hossein Bassir


Aims: The present systematic review and meta-analysis aimed to evaluate the long-term efficacy of periodontal regenerative procedures for the treatment of intrabony periodontal defects after at least 5 years of follow-up. Materials and methods: Electronic literature database search was performed in CINAHL, EMBASE, PubMed, and Web of Science. Additionally, a manual search of literature was performed. Studies conducted in human subjects with intrabony periodontal defects treated using periodontal regenerative therapy and a minimum follow-up period of 5-years were included. Studies had to provide quantitative outcomes for change in clinical attachment level (CAL; primary outcome variable), tooth retention, change in pocket probing depth (PPD) or radiographic vertical defect fill. Data from included studies were pooled to estimate effect size. Results: Thirty-eight citations met the inclusion criteria. Quantitative analysis showed a mean gain in CAL of 3.47 mm (p<0.001; 95% CI: 3.13; 3.82) after at least 5 years following therapy. Tooth retention rate was 92.8% (95% CI: 0.91; 0.94) and 87.7% (95% CI: 0.83; 0.91) after at least 5 years and 10 years of follow-up, respectively. The pooled data demonstrated a mean reduction of 4.06 mm in PPD (p<0.001; 95% CI: 3.65; 4.48) and a mean radiographic vertical defect fill of 3.69 mm (p<0.001; 95% CI: 2.83; 4.55). Conclusions: Periodontal regenerative procedures for the treatment of intrabony defects result in long-term tooth retention, defect reduction, and lasting improvements in clinical attachment level and pocket probing depth.

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