Publication date: Available online 30 July 2018
Source: Journal of Oral and Maxillofacial Surgery
Author(s): Octavi Camps-Font, Cristina Caro-Bonfill, Maria Àngels Sánchez-Garcés, Cosme Gay-Escoda
Abstract
Background
To assess which regenerative techniques are most effective for preventing periodontal defects after the extraction of the third molars and compare these procedures with the spontaneous healing of the socket.
Methods
Five electronic databases were searched to identify randomized clinical trials that fulfilled the eligibility criteria. 2 independent reviewers conducted literature screening, article selection, and data extraction independent reviewers. Outcome measures were mean clinical attachment level (CAL) gain, mean probing depth (PD) reduction, mean alveolar bone level (ABL) gain and adverse events. The influence of several variables of interest on the outcomes of periodontal regenerative therapy was explored via subgroup analyses.
Results
Out of 1,205 potentially eligible papers, 21 randomized clinical trials were included. 18 trials assessed periodontal regenerative therapy as an alternative to extraction alone. Statistically significant differences were found in CAL gain (1.98 mm; 95% CI: 1.44 to 2.52; p<0.001), PD reduction (1.76 mm; 95% CI: 1.20 to 2.31; p<0.001) and ABL gain (1.21 mm; 95% CI: 0.21 to 2.21; p=0.018). The risk of developing complications at treated sites did not increase with the regenerative procedures (OR: 1.49; 95% CI: 0.71 to 3.14; p=0.290). There was no evidence of any regenerative procedure being better than any other. However, osseous grafting techniques were associated with a significantly higher adverse event rate.
Conclusion
Regenerative periodontal therapy, compared to the spontaneous healing of the wound, is more effective at initial improvement in CAL gain, PD reduction, and ABL gain, without increasing the risk of postoperative complications.
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