Clinical efficacy of periosteal pedicle graft as a barrier membrane in guided tissue regeneration: A systematic review and meta-analysis

Abstract

Background: The study aims to assess the clinical efficacy of periosteal pedicle graft (PPG) as a barrier membrane in guided tissue regeneration (GTR) for gingival recession, intrabony, and furcation defects. Materials and Methods: Electronic and hand searches were performed to identify randomized controlled/clinical trials investigating GTR using PPG, with 6-month follow-up. Primary outcomes recorded: probing depth (PD), clinical attachment level (CAL), bone fill, recession depth (RD) reduction, percentage of mean root coverage, keratinized tissue width (KTW), and bone defect area (BDA). Results: Thirteen articles were selected; 6 for recession, 2 for furcation, and 5 for intrabony. Meta-analysis was performed whenever possible, results expressed as pooled standardized mean differences (SMDs). In recession defects, the RD pooled SMD is 0.47 (95% confidence interval (CI) = [−0.50–1.44]), KTW pooled SMD is 1.30 (95% CI = [−0.30–2.91]), favoring PPG over the comparator. In furcation defects, PD pooled SMD is 1.12 (95% CI = [−2.77–0.52]), CAL pooled SMD is 0.71 (95% CI = [−1.09–2.50]), and bone fill pooled SMD is 0.67 (95% CI = [−3.34–4.69]) favoring PPG. In intrabony defects, PD pooled SMD is 0.54 (95% CI = [−2.12–1.04]), CAL pooled SMD is 0.23 (95% CI = [−1.13–0.68]), and BDA pooled SMD is 0.37 (95% CI = [−1.58–2.31]) favoring PPG. The results were not statistically significant. Conclusion: The current evidence indicates that PPG constitutes a valid and reliable alternative to collagen barrier membranes for successful GTR.

Keywords

• collagen membrane
• connective tissue graft
• guided tissue regeneration
• open flap debridement
• periodontal regeneration
• periosteal graft
• periosteal pedicle graft