Efficacy of regenerative therapy in aggressive periodontitis: a systematic review and meta-analysis of randomised controlled clinical trials. 2020

Lucía Díaz-Faes, and Ana Fernández-Somoano, and Antonio Magán-Fernández, and Francisco Mesa
Department of Periodontics, Faculty of Dentistry, University of Granada, Granada, Spain. luciadiazfaes@correo.ugr.es.

OBJECTIVE To analyse evidence regarding the efficacy of periodontal regenerative procedures in intrabony defects in patients treated for aggressive periodontitis (AgP). METHODS A systematic search of the literature for randomised controlled clinical trials including patients treated for aggressive periodontitis that compared a group treated with regenerative therapy with another group treated with surgical debridement alone was conducted by two independent reviewers. RESULTS Six studies were included in the meta-analysis of clinical and/or radiographic parameters at 6 and 12 months. Probing pocket depth was smaller at 6 months in patients treated with regenerative therapies compared with those treated with regular debridement (1.00 mm, p < 0.001, 95% CI (0.67, 1.34)). At 12 months this difference was more marked (0.41 mm, p = 0.12, 95% CI (- 0.10, 0.91)). The distance between the cemento-enamel junction and the alveolar crest at both 6 (1.36 mm, p < 0.001, 95% CI (1.03, 1.68)) and 12 months (0.90 mm, p = 0.01, 95% CI (0.24, 1.56)) was smaller in the group treated with regeneration. CONCLUSIONS The use of biomaterials for regenerative therapy in AgP may be more effective than surgical debridement. Better outcomes were observed in terms of probing pocket depth and distance between the cemento-enamel junction and the alveolar crest at 6 months. Regeneration should be considered as a therapy to prevent tooth loss, although more studies with larger sample size and longer follow-up are needed. CONCLUSIONS Periodontal regeneration is effective in the treatment of intrabony defects in patients with AgP, as it leads to better outcomes in clinical and radiographic parameters.

UI MeSH Term Description Entries
D010520 Aggressive Periodontitis Inflammation and loss of PERIODONTIUM that is characterized by rapid attachment loss and bone destruction in the presence of little local factors such as DENTAL PLAQUE and DENTAL CALCULUS. This highly destructive form of periodontitis often occurs in young people and was called early-onset periodontitis, but this disease also appears in old people. Periodontitis, Juvenile,Periodontitis, Prepubertal,Periodontosis,Early-Onset Periodontitis,Juvenile Periodontitis,Periodontitis, Aggressive, 1,Periodontitis, Circumpubertal,Prepubertal Periodontitis,Circumpubertal Periodontitis,Early Onset Periodontitis,Early-Onset Periodontitides,Juvenile Periodontitides,Periodontitides, Early-Onset,Periodontitides, Juvenile,Periodontitis, Aggressive,Periodontitis, Early-Onset,Periodontoses
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000539 Alveolar Process The thickest and spongiest part of the maxilla and mandible hollowed out into deep cavities for the teeth. Alveolar Ridge,Alveolar Processes,Process, Alveolar,Processes, Alveolar,Ridge, Alveolar
D016032 Randomized Controlled Trials as Topic Works about clinical trials that involve at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table. Clinical Trials, Randomized,Controlled Clinical Trials, Randomized,Trials, Randomized Clinical
D016557 Guided Tissue Regeneration, Periodontal Techniques for enhancing and directing cell growth to repopulate specific parts of the PERIODONTIUM that have been damaged by PERIODONTAL DISEASES; TOOTH DISEASES; or TRAUMA, or to correct TOOTH ABNORMALITIES. Repopulation and repair is achieved by guiding the progenitor cells to reproduce in the desired location by blocking contact with surrounding tissue by use of membranes composed of synthetic or natural material that may include growth inducing factors as well. Guided Periodontal Tissue Regeneration,Periodontal Guided Tissue Regeneration,Regeneration, Periodontal Guided Tissue
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D057747 Periodontal Debridement Removal or disruption of DENTAL DEPOSITS and plaque-retentive DENTAL CALCULUS from tooth surfaces and within the periodontal pocket space without deliberate removal of CEMENTUM as done in ROOT PLANING and often in DENTAL SCALING. The goal is to conserve dental cementum to help maintain or re-establish healthy periodontal environment and eliminate PERIODONTITIS by using light instrumentation strokes and nonsurgical techniques (e.g., ultrasonic, laser instruments). Nonsurgical Periodontal Debridement,Periodontal Pocket Debridement,Debridement, Nonsurgical Periodontal,Debridement, Periodontal,Debridement, Periodontal Pocket,Debridements, Nonsurgical Periodontal,Debridements, Periodontal,Debridements, Periodontal Pocket,Nonsurgical Periodontal Debridements,Periodontal Debridement, Nonsurgical,Periodontal Debridements,Periodontal Debridements, Nonsurgical,Periodontal Pocket Debridements

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