Skip to main content
Erschienen in: Clinical Oral Investigations 3/2021

12.01.2021 | Review

Bone replacement grafts with guided tissue regeneration in treatment of grade II furcation defects: a systematic review and meta-analysis

verfasst von: Renuka K. Swami, Abhay P. Kolte, Girish H. Bodhare, Rajashri A. Kolte

Erschienen in: Clinical Oral Investigations | Ausgabe 3/2021

Einloggen, um Zugang zu erhalten

Abstract

Aim

The present systematic review appended with meta-analysis aimed to evaluate the efficacy of bone replacement graft (BRG) with guided tissue regeneration (GTR) over BRG or open flap debridement (OFD) alone in the treatment of grade II furcation defects.

Materials and methods

An electronic literature search of PubMed, Cochrane Library and Google Scholar databases accompanied with manual searching was done. Randomized controlled trials (RCTs) up to October 2019, comparing BRG+GTR with BRG or OFD in grade II furcation defects, were identified. Clinical attachment level (CAL) gain, changes in gingival marginal level (GML), vertical defect fill (VDF), horizontal defect fill (HDF) and reduction in defect volume were the outcome parameters.

Results

Of a total of 12, 9 studies compared BRG+GTR vs BRG while 3 compared BRG+GTR vs OFD. Meta-analysis was carried out for CAL gain, VDF, HDF and GML changes. In the BRG+GTR vs BRG comparison group, out of 9 studies, 6 RCTs showed standardized mean difference (SMD) of 0.513 for VDF, 9 RCTs showed SMD of 0.83 for HDF and 2 RCTs showed SMD of 0.651 for CAL gain, whereas only 2 studies in the same group reported reduction in defect volume. Three studies of the BRG+GTR vs OFD group exhibited significant VDF and CAL gain with SMD of 2.002 and 1.161 respectively. However, no significant change was recorded for GML in both groups.

Conclusion

The present systematic review indicates supplemental benefits of combination therapy of BRG+GTR over monotherapy in resolving grade II furcation defects.

Clinical relevance

In our quest to achieve maximum regeneration in grade II furcation defects, combination therapies such as BRG+GTR have been accepted as treatment choices over other modalities. Clinical situations warranting near-complete regeneration of the tissues in such defects are better suited for combination therapies.
Literatur
1.
Zurück zum Zitat Page RC, Schroeder HE (1976) Pathogenesis of inflammatory periodontal disease. A summary of current work. Lab Investig 34:235–249PubMed Page RC, Schroeder HE (1976) Pathogenesis of inflammatory periodontal disease. A summary of current work. Lab Investig 34:235–249PubMed
2.
Zurück zum Zitat Kalkwarf KL, Kaldahl WB, Patil KD (1988) Evaluation of furcation region response to periodontal therapy. J Periodontol 59:794–804CrossRef Kalkwarf KL, Kaldahl WB, Patil KD (1988) Evaluation of furcation region response to periodontal therapy. J Periodontol 59:794–804CrossRef
3.
Zurück zum Zitat Matia JI, Bissada NF, Maybury JE, Richetti P (1986) Efficiency of scaling of the molar furcation area with and without surgical access. Int J Periodontics Restorative Dent 6:24–35PubMed Matia JI, Bissada NF, Maybury JE, Richetti P (1986) Efficiency of scaling of the molar furcation area with and without surgical access. Int J Periodontics Restorative Dent 6:24–35PubMed
8.
Zurück zum Zitat Burnsvold MA, Mellonig JT (2000) Bone grafts and periodontal regeneration. Periodontol 1:80–91CrossRef Burnsvold MA, Mellonig JT (2000) Bone grafts and periodontal regeneration. Periodontol 1:80–91CrossRef
9.
Zurück zum Zitat Hirschfeld L, Wasserman B (1978) A Long-term survey of tooth loss in 600 treated periodontal patients. J Periodontol 49:225–237CrossRef Hirschfeld L, Wasserman B (1978) A Long-term survey of tooth loss in 600 treated periodontal patients. J Periodontol 49:225–237CrossRef
12.
Zurück zum Zitat Sánchez-Pérez A, Moya-Villaescusa MJ (2009) Periodontal disease affecting tooth furcations. A review of the treatments available. Med Oral Patol Oral Cir Bucal 14:554–557CrossRef Sánchez-Pérez A, Moya-Villaescusa MJ (2009) Periodontal disease affecting tooth furcations. A review of the treatments available. Med Oral Patol Oral Cir Bucal 14:554–557CrossRef
13.
Zurück zum Zitat Froum SJ, Gomez C, Breault MR (2002) Current concepts of periodontal regeneration. N Y State Dent J 68:14–22PubMed Froum SJ, Gomez C, Breault MR (2002) Current concepts of periodontal regeneration. N Y State Dent J 68:14–22PubMed
22.
Zurück zum Zitat Feijo CV, Lucena JG, Kurita LM, Pereira SL (2012) Evaluation of cone beam computed tomography in the detection of horizontal periodontal bone defects: a in vivo study. Int J Periodontics Restorative Dent 32:e162–e168PubMed Feijo CV, Lucena JG, Kurita LM, Pereira SL (2012) Evaluation of cone beam computed tomography in the detection of horizontal periodontal bone defects: a in vivo study. Int J Periodontics Restorative Dent 32:e162–e168PubMed
23.
Zurück zum Zitat Bodhare GH, Kolte AP, Kolte RA, Shirke PY (2019) Clinical and radiographic evaluation and comparison of bioactive bone alloplast morsels when used alone and in combination with platelet-rich fibrin in the treatment of periodontal intrabony defects-a randomized controlled trial. J Periodontol 90:584–594. https://doi.org/10.1002/JPER.18-0416CrossRefPubMed Bodhare GH, Kolte AP, Kolte RA, Shirke PY (2019) Clinical and radiographic evaluation and comparison of bioactive bone alloplast morsels when used alone and in combination with platelet-rich fibrin in the treatment of periodontal intrabony defects-a randomized controlled trial. J Periodontol 90:584–594. https://​doi.​org/​10.​1002/​JPER.​18-0416CrossRefPubMed
28.
Zurück zum Zitat Higgins JP, Altman DG, Sterne JAC (2011) Assessing risk of bias in included studies (Chapter 8). In J. P. Higgins & S. Green (Eds.), Cochrane handbook for systematic reviews of interventions. Version 5.1.0 [updated March 2011]. The Cochrane Collaboration. Retrieved from www.handbook.cochrane.org Higgins JP, Altman DG, Sterne JAC (2011) Assessing risk of bias in included studies (Chapter 8). In J. P. Higgins & S. Green (Eds.), Cochrane handbook for systematic reviews of interventions. Version 5.1.0 [updated March 2011]. The Cochrane Collaboration. Retrieved from www.​handbook.​cochrane.​org
32.
Zurück zum Zitat Pradeep AR, Karvekar S, Nagpal K, Patnaik K, Raju A, Singh P (2016) Rosuvastatin 1.2 mg in situ gel combined with 1:1 mixture of autologous platelet-rich fibrin and porous hydroxyapatite bone graft in surgical treatment of mandibular class II furcation defects: a randomized clinical control trial. J Periodontol 87:5–13. https://doi.org/10.1902/jop.2015.150131CrossRefPubMed Pradeep AR, Karvekar S, Nagpal K, Patnaik K, Raju A, Singh P (2016) Rosuvastatin 1.2 mg in situ gel combined with 1:1 mixture of autologous platelet-rich fibrin and porous hydroxyapatite bone graft in surgical treatment of mandibular class II furcation defects: a randomized clinical control trial. J Periodontol 87:5–13. https://​doi.​org/​10.​1902/​jop.​2015.​150131CrossRefPubMed
35.
Zurück zum Zitat Jalaluddin M, Patel RK, Almalki SA, Nagdev P, Roshan R, Varkey RR (2019) Assessment of the efficacy of periodontal tissue regeneration using non-resorbable and bioabsorbable GTR membrane-a clinical comparative study. J Contemp Dent Pract 20:675–679CrossRef Jalaluddin M, Patel RK, Almalki SA, Nagdev P, Roshan R, Varkey RR (2019) Assessment of the efficacy of periodontal tissue regeneration using non-resorbable and bioabsorbable GTR membrane-a clinical comparative study. J Contemp Dent Pract 20:675–679CrossRef
37.
Zurück zum Zitat Kannan AL, Bose BB, Muthu J, Perumalsamy R, Pushparajan S, Namasivayam A (2014) Efficacy of combination therapy using anorganic bovine bone graft with resorbable GTR membrane vs. open flap debridement alone in the management of grade II furcation defects in mandibular molars - a comparative study. J Int Soc Prev Community Dent 4:S38–S43. https://doi.org/10.4103/2231-0762.142992CrossRefPubMedPubMedCentral Kannan AL, Bose BB, Muthu J, Perumalsamy R, Pushparajan S, Namasivayam A (2014) Efficacy of combination therapy using anorganic bovine bone graft with resorbable GTR membrane vs. open flap debridement alone in the management of grade II furcation defects in mandibular molars - a comparative study. J Int Soc Prev Community Dent 4:S38–S43. https://​doi.​org/​10.​4103/​2231-0762.​142992CrossRefPubMedPubMedCentral
38.
Zurück zum Zitat Agrawal A, Manjunath RGS, Sethi P, Shankar GS (2020) Platelet-rich fibrin in combination with decalcified freeze-dried bone allograft for the management of mandibular degree II furcation defect: a randomized controlled clinical trial. Singapore Dent J 1-8. doi:https://doi.org/10.1142/S2214607519500032 Agrawal A, Manjunath RGS, Sethi P, Shankar GS (2020) Platelet-rich fibrin in combination with decalcified freeze-dried bone allograft for the management of mandibular degree II furcation defect: a randomized controlled clinical trial. Singapore Dent J 1-8. doi:https://​doi.​org/​10.​1142/​S221460751950003​2
39.
Zurück zum Zitat Reddy KP, Nayak DG, Uppoor AS (2006) A clinical evaluation of anorganic bovine bone graft plus 10% collagen with or without a barrier in the treatment of class II furcation defects. J Contemp Dent Pract 7:60–70CrossRef Reddy KP, Nayak DG, Uppoor AS (2006) A clinical evaluation of anorganic bovine bone graft plus 10% collagen with or without a barrier in the treatment of class II furcation defects. J Contemp Dent Pract 7:60–70CrossRef
45.
Zurück zum Zitat Pajnigara NG, Kolte AP, Kolte RA, Pajnigara NG (2017) Volumetric assessment of regenerative efficacy of demineralized freeze-dried bone allograft with or without amnion membrane in grade II furcation defects: a cone beam computed tomography study. Int J Periodontics Restorative Dent 37:255–262. https://doi.org/10.11607/prd.2901CrossRefPubMed Pajnigara NG, Kolte AP, Kolte RA, Pajnigara NG (2017) Volumetric assessment of regenerative efficacy of demineralized freeze-dried bone allograft with or without amnion membrane in grade II furcation defects: a cone beam computed tomography study. Int J Periodontics Restorative Dent 37:255–262. https://​doi.​org/​10.​11607/​prd.​2901CrossRefPubMed
54.
59.
Zurück zum Zitat Marinescu AG, Carligeriu V, Nica L et al (2011) Evaluation of treatment techniques for advanced (grade II - IV) furcation defects. A literature review of the regenerative methods. Timisoara Med J 61:115–124 Marinescu AG, Carligeriu V, Nica L et al (2011) Evaluation of treatment techniques for advanced (grade II - IV) furcation defects. A literature review of the regenerative methods. Timisoara Med J 61:115–124
63.
Zurück zum Zitat Christgau M, Schmalz G, Reich E et al (1995) Clinical and radiographical split-mouth study on resorbable versus non-resorbable GTR-membranes. J Clin Periodontol 22:306–15. 40CrossRef Christgau M, Schmalz G, Reich E et al (1995) Clinical and radiographical split-mouth study on resorbable versus non-resorbable GTR-membranes. J Clin Periodontol 22:306–15. 40CrossRef
Metadaten
Titel
Bone replacement grafts with guided tissue regeneration in treatment of grade II furcation defects: a systematic review and meta-analysis
verfasst von
Renuka K. Swami
Abhay P. Kolte
Girish H. Bodhare
Rajashri A. Kolte
Publikationsdatum
12.01.2021
Verlag
Springer Berlin Heidelberg
Erschienen in
Clinical Oral Investigations / Ausgabe 3/2021
Print ISSN: 1432-6981
Elektronische ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-021-03776-0

Weitere Artikel der Ausgabe 3/2021

Clinical Oral Investigations 3/2021 Zur Ausgabe

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Klinikreform soll zehntausende Menschenleben retten

15.05.2024 Klinik aktuell Nachrichten

Gesundheitsminister Lauterbach hat die vom Bundeskabinett beschlossene Klinikreform verteidigt. Kritik an den Plänen kommt vom Marburger Bund. Und in den Ländern wird über den Gang zum Vermittlungsausschuss spekuliert.

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Klinik aktuell Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Update Zahnmedizin

Bestellen Sie unseren kostenlosen Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.