Cochrane · intervention · CD001724
Guided tissue regeneration for periodontal infra-bony defects
Cochrane Database of Systematic Reviews · 2006 · Cochrane Library
Full textEvery question was extracted from the full review (methods and results), not only its Summary of Findings table.
Questions
18
current version
GRADE rated
0
No studies
4
Included studies
17
as reported
No studies 4 · 22.2%Ungraded 14 · 77.8%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients with chronic periodontitis (aged 21 years or older) with periodontal infra-bony defects; furcation-involved teeth and aggressive periodontitis excluded | Age range of included studies 21 to 81 years; both sexes in all studies; one study with majority smokers (21 of 38) |
| Intervention | Guided tissue regeneration (GTR) alone; GTR combined with bone substitutes | GTR alone (n=16 studies); GTR + bone substitutes (n=2 studies) |
| Comparison | Open flap debridement (access flap surgery) | Open flap debridement (n=17) |
| Outcomes | Primary: tooth loss; change in attachment levels; patient well-being or quality of life. Secondary: change in probing depths; change in gingival recession; changes in bone/hard tissue (radiographic; hard tissue probing at surgical re-entry); disease recurrence; percentage of sites with <=4 mm probing depth at completion; aesthetics; post-operative complications; economic outcomes | Attachment level change (n=16); sites failing to gain 2 mm attachment (n=6); probing depth reduction (n=11); gingival recession (n=9); radiographic bone change (n=2); hard tissue probing at re-entry (n=3); tooth loss (n=17, none reported); adverse effects/membrane exposure (n=16); patient morbidity/pain (n=1); treatment time (n=1) |
| Study designs | Randomised controlled trials of at least 12 months duration | 8 parallel-group and 8 split-mouth RCTs (two studies with both elements); 17 total |
| Timing | At least 12 months duration | 12 months minimum follow-up |
Search date: 2004-04. Databases: Cochrane Oral Health Group Trials Register; MEDLINE; EMBASE; Journal of Periodontology; Journal of Clinical Periodontology; Journal of Periodontal Research
Questions and results
Show all 2 versionsGuided tissue regeneration (GTR) with barrier membrane (resorbable or non-resorbable) vs Open flap debridement (access flap surgery)
Population: Patients with chronic periodontitis (aged 21 years or older) with periodontal infra-bony defects; furcation-involved teeth and aggressive periodontitis excluded
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Cost/benefit (treatment time plus estimated material costs) | No data were found for this outcome (listed under 'Other outcomes: No data were found for the following outcomes'). | 0 studies | No studies |
Aesthetics (patient's opinion) | No data were found for this outcome (listed under 'Other outcomes: No data were found for the following outcomes'). | 0 studies | No studies |
Change in clinical attachment level (attachment gain) >=12 months | MD 1.22 [0.80, 1.64] | 16 studies | Ungraded |
Hard tissue probing at surgical re-entry (bone gain) >=12 months | MD 1.39 [1.08, 1.71] | 3 studies | Ungraded |
Tooth loss | No tooth loss was reported in any study although these data are incomplete where patient follow-up was not complete (no events; no estimable effect). | 17 studies | Ungraded |
Treatment / surgical procedure time | MD 23.9 | 1 study | Ungraded |
Radiographic bone change >=12 months | Radiographic data was contained in two studies. Mayfield 1998 showed 0.6 mm gain in bone from the base of the defect in both test and control groups; Ratka-Kruger 2000 reported descriptively that only minute changes in… | 2 studies | Ungraded |
Change in gingival recession >=12 months | MD 0.26 [0.08, 0.43] | 9 studies | Ungraded |
Sites failing to gain 2 mm attachment (proportion) >=12 months | RR 0.54 [0.31, 0.96] | 6 studies | Ungraded |
Change in probing depth (probing depth reduction) >=12 months | MD 1.21 [0.53, 1.88] | 11 studies | Ungraded |
Disease recurrence (% sites with >=2 mm loss of probing attachment from 12 months after treatment) | No data were found for this outcome (listed under 'Other outcomes: No data were found for the following outcomes'). | 0 studies | No studies |
Ease of maintenance (% of sites with <4 mm probing depth) | No data were found for this outcome (listed under 'Other outcomes: No data were found for the following outcomes'). | 0 studies | No studies |
Patient well-being / quality of life | Cortellini 2001: 36% of GTR patients reported the procedure interfered with daily activity for an average of 2.7 days versus 32% of controls for an average of 2.4 days; no significant difference for postoperative pain… | 1 study | Ungraded |
Post-operative complications / adverse effects (including pain, infection) | Adverse effects were generally minor. Healing was generally uneventful for both test and control groups. Exposure of the GTR barrier membrane was widely reported, ranging from 20% of sites (non-resorbable… | 16 studies | Ungraded |
Guided tissue regeneration (GTR) combined with bone substitutes/graft vs Open flap debridement (access flap surgery)
Population: Patients with chronic periodontitis (aged 21 years or older) with periodontal infra-bony defects; furcation-involved teeth and aggressive periodontitis excluded
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Hard tissue probing at surgical re-entry (bone gain) >=12 months | MD 3.37 [3.14, 3.61] | 1 study | Ungraded |
Change in clinical attachment level (attachment gain) >=12 months | MD 1.25 [0.89, 1.61] | 2 studies | Ungraded |
Change in probing depth (probing depth reduction) >=12 months | MD 1.24 [0.89, 1.59] | 2 studies | Ungraded |
Change in gingival recession >=12 months | MD -0.33 [-0.43, -0.23] | 1 study | Ungraded |