A systematic review and meta-analysis of guided tissue regeneration/osseous grafting for the treatment of Class II furcation defects

Abstract

Background/purpose: The purpose of this article was to conduct a systematic review of the clinical evidence on the efficacy of guide tissue regeneration (GTR) with/without osseous grafting (OG) in treating periodontal furcation Class II defects. Materials and methods: Reports from randomized controlled clinical trials, with at least 6 months follow-up, comparing open flap debridement (OFD); GTR, and GTR + OG were located from various sources. Sources included the electronic databases of Cochrane Oral Health Group specialist trials register, MEDLINE, and PubMed; in addition, journal archives were hand-searched. Trials up to and including March 2012 were included. Using the PICO (Patient or Problem, Intervention, Comparison, and Outcome) question format, data from eligible articles were extracted and meta-analyzed. The outcomes measures were furcation closure rate, vertical/horizontal bone fill (re-entry), and vertical/horizontal attachment level gain. Results: The meta-analysis showed that the GTR and GTR + OG groups obtained greater furcation closure rate, vertical/horizontal bone fill, and vertical/horizontal attachment level gain than the OFD group in mandibular molars. The GTR group obtained greater vertical/horizontal bone fill and vertical attachment level gain than the OFD group in maxillary molars. The GTR + OG group achieved better clinical outcomes than the GTR group did in all the comparing outcomes in mandibular molars. Conclusion: GTR technique seemed to be more effective than OFD for resolving Class II periodontal furcation defects, and the GTR + OG technique showed even better clinical results. The outcomes were better for mandibular molars than for maxillary molars.

Keywords

• bone grafting
• furcation defects
• guided tissue regeneration
• meta-analysis
• systematic review