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A systematic review of graft materials and biological agents for periodontal intraosseous defects
Author(s) -
Trombelli Leonardo,
HeitzMayfield Lisa J.A.,
Needleman Ian,
Moles David,
Scabbia Alessandro
Publication year - 2002
Publication title -
journal of clinical periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.456
H-Index - 151
eISSN - 1600-051X
pISSN - 0303-6979
DOI - 10.1034/j.1600-051x.29.s3.7.x
Subject(s) - medicine , biomaterial , significant difference , mean difference , dentistry , placebo , biological effect , randomized controlled trial , biological materials , surgery , biomedical engineering , pathology , confidence interval , alternative medicine
Objectives: To determine the adjunctive effect of grafting biomaterials/biological agents with open flap debridement (OFD) in the treatment of deep intraosseous defects. Background: No systematic review of treatment outcomes in patients who received graft biomaterials or biological agents have been published. Methods: A rigorous systematic review of randomized controlled trials of at least 6‐month duration was conducted comparing grafting biomaterials/biological agents (alone or in combination) + OFD (test group) to OFD alone or in combination with a placebo (control group). Results: The difference in CAL change between test and control groups varied from −1.45 mm to 1.40 mm with respect to different biomaterials/biological agents. Meta‐analysis showed that CAL change significantly improved after treatment for coralline calcium carbonate (weighted mean difference 0.90 mm; 95% CI: 0.53–1.27), bioactive glass (weighted mean difference 1.04 mm; 95% CI: 0.31–1.76), hydroxyapatite (weighted mean difference 1.40 mm, 95% CI 0.64–2.16), and enamel matrix proteins (weighted mean difference 1.33 mm, 95% CI 0.78–1.88). However, heterogeneity in results between studies was highly statistically significant for most of biomaterials/biologicals and could not be fully explained. Conclusions: Overall, the use of specific biomaterials/biologicals was more effective than OFD in improving attachment levels in intraosseous defects. Difference in CAL gain varied greatly with respect to different biomaterial/biological agent. Due to a significant heterogeneity in results between studies in most treatment groups, general conclusions about the expected clinical benefit of graft biomaterials/biologicals need to be interpreted with caution. Further research should focus on understanding this variability.