Abstract
Data sources
The Cochrane Oral Health Group specialist trials, Medline and Embase databases were searched. The Journal of Clinical Periodontal Research and the Journal of Clinical Periodontology were hand searched.
Study selection
Randomised controlled trials involving an intervention of surgical flap or periodontal pocket surgery including simplified, modified, access, Widman, or papilla preservation and disease or intrabony/intraosseous defect were included. Two authors screened and selected the studies.
Data extraction and synthesis
Data extraction and risk of bias assessment were conducted by two authors. Primary outcomes were tooth survival, clinical attachment gain, probing depth reduction and gingival recession increase. Weighted means and forest plots were calculated and meta-analysis performed.
Results
Thirty-one studies were included for data analysis. Twelve months after conservative surgery, tooth survival was 98%, clinical attachment loss gain 1.65 mm (95% CI 1.37-1.94), probing depth reduction 2.8 mm (CI 2.43-3.18) and gingival recession increase 1.26 mm (CI 0.94-1.49). Longer follow up showed similar results. There was insignificant evidence to suggest that clinical bone increased with this surgery.
Conclusions
The treatment of intrabony defect with conservative surgery is associated with high tooth retention and improvement of periodontal clinical parameters. Clinical performance may vary according to the type of surgical flap used.
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Authors and Affiliations
Additional information
Address for correspondence: Filippo Graziani, Department of Surgery, Unit of Dentistry and Oral Surgery, University of Pisa, Pisa, Italy. E-mail: filippo.graziani@med.unipi.it
Graziani F, Gennai S, Cei S et al. Clinical performance of access flap surgery in the treatment of the intrabony defect. A systematic review and meta-analysis of randomized clinical trials. J Clin Periodontol 2012; 39: 145–156.
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Duane, B. Conservative periodontal surgery for treatment of intrabony defects is associated with improvements in clinical parameters. Evid Based Dent 13, 115–116 (2012). https://doi.org/10.1038/sj.ebd.6400898
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DOI: https://doi.org/10.1038/sj.ebd.6400898
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