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Clinical performance of access flap in the treatment of class II furcation defects. A systematic review and meta‐analysis of randomized clinical trials
Author(s) -
Graziani Filippo,
Gennai Stefano,
Karapetsa Dimitra,
Rosini Stefano,
Filice Natalia,
Gabriele Mario,
Tonetti Maurizio
Publication year - 2015
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 - 10.1111/jcpe.12327
Subject(s) - furcation defect , medicine , meta analysis , dentistry , randomized controlled trial , class (philosophy) , computer science , surgery , pathology , molar , artificial intelligence
Objectives To systematically review the performance of access flap ( OFD ) in the treatment of class II furcation defects ( FD ). Methods RCT s evaluating surgical treatment of class II FD with OFD , minimum 6 months follow‐up were identified. Screening, data extraction, and quality assessment were conducted independently by three reviewers. The primary outcomes were tooth survival and change in the horizontal clinical attachment level ( HCAL ). Changes in vertical clinical attachment level ( VCAL ), reduction of pocket probing depth ( PPD ), recession increase ( REC ), horizontal ( HBL ), and vertical bone level ( VBL ) were also collected. Results The search identified 1571 studies out of which 11 articles met the inclusion criteria. Data analysis was performed on 199 patients and 251 FD . Tooth survival was seldom reported. Altogether with inflammatory amelioration, the weighted mean differences were for HCAL 0.96 mm [ CI : (0.60, 1.32), p < 0.001], 0.55 mm [ CI : (0.00, 1.10), p = 0.05] for VCAL gain. PPD reduction over 6 months was 1.38 mm [ CI : (0.91, 1.85), p < 0.01]. Potential risk of bias was identified. Conclusions Teeth with mandibular class II furcation involvement treated with OFD show significant clinical improvements 6 months after surgery. Nevertheless, in order to better understand the magnitude of these changes and their clinical relevance, prospective long‐term trials are needed.