Long‐term clinical outcomes of periodontal regeneration of intrabony defects: A systematic review and meta‐analysis

作者：Hom‐Lay Wang, Parham Hazrati, Javier Calatrava, Muhammad H. A. Saleh, Abdusalam Alrmali · 发表于：Periodontology 2000 · 年份：2025 · DOI：10.1111/prd.70002 · 被引用次数：9 · 研究领域：Periodontal Regeneration and Treatments、Dental Implant Techniques and Outcomes、Oral microbiology and periodontitis research

This systematic review and meta-analysis aimed to evaluate the long-term clinical outcomes of regenerative procedures compared with access flap surgery for the treatment of intrabony defects, with a minimum follow-up period of 5 years. A systematic review protocol following PRISMA guidelines was conducted. Both electronic and manual searches were conducted to identify randomized clinical trials (RCTs) on regenerative treatment of deep intrabony defects (≥3 mm) with a follow-up of at least 5 years. Primary outcome variables were probing depth (PD) reduction, clinical attachment level (CAL) gain, recession depth (REC) and tooth loss. Meta-analyses and meta-regressions were performed using random-effects models. Seventeen RCTs published from 2004 to 2022, accounting for 501 defects, with follow-ups ranging from 5 to 20 years, were included. Thirteen studies with some concerns and four with high risks of bias were identified. Meta-analyses revealed that after ≥5 years of follow-up, guided tissue regeneration (GTR) on the intrabony defect resulted in significant CAL gain (3.27 mm; 95% CI: 2.90-3.65) and PD reduction (4.04 mm; 95% CI: 3.69-4.38) compared with baseline. After ≥5 years, regenerative procedures with biologics, bone grafts, or both showed significant improvements in CAL gain (3.21 mm; 95% CI: 2.72-3.70) and PD reduction (3.92 mm; 95% CI: 3.39-4.44). GTR on the intrabony defects obtained higher long-term CAL gain (1.52 mm; 95% CI: 0.06-3.10) and PD reduction (0.89 mm; 9...