Non-Cochrane · intervention · PM41251445
Long-term clinical benefits of periodontal interventions in strict supportive periodontal care: A systematic review.
Rattu Varkha, Patel Tishani, Loke Jasmine, et al. · Journal of periodontology · 2026 · PubMed · doi:10.1002/jper.70027
Findings
12 findings
| Population | ||||
|---|---|---|---|---|
| Adults with periodontitis and intrabony defects who completed active periodontal therapy and attended strict supportive periodontal care for at least 10 years | Guided tissue regeneration (GTR) in intrabony defects | Open flap debridement (OFD) or access flap | Probing pocket depth (PPD) baseline · Supportive periodontal care after active periodontal therapy · Meta-analysis of studies comparing GTR and OFD | WMD -0.03 [-0.44, 0.38] GRADE not reported 3 studies |
| Adults with periodontitis and intrabony defects who completed active periodontal therapy and attended strict supportive periodontal care for at least 10 years | Guided tissue regeneration (GTR) in intrabony defects | Open flap debridement (OFD) or access flap | Probing pocket depth (PPD) 1 year · Supportive periodontal care after active periodontal therapy · Meta-analysis of studies comparing GTR and OFD | WMD -0.76 [-1.60, 0.09] GRADE not reported 3 studies |
| Adults with periodontitis and intrabony defects who completed active periodontal therapy and attended strict supportive periodontal care for at least 10 years | Guided tissue regeneration (GTR) in intrabony defects | Open flap debridement (OFD) or access flap | Clinical attachment level (CAL) baseline · Supportive periodontal care after active periodontal therapy · Meta-analysis of studies comparing GTR and OFD | WMD 0.00 [-0.42, 0.41] GRADE not reported 3 studies |
| Adults with periodontitis and intrabony defects who completed active periodontal therapy and attended strict supportive periodontal care for at least 10 years | Guided tissue regeneration (GTR) in intrabony defects | Open flap debridement (OFD) or access flap | Clinical attachment level (CAL) respective endpoints (10 to 20 years) · Supportive periodontal care after active periodontal therapy · Meta-analysis of studies comparing GTR and OFD | WMD -0.74 [-1.74, 0.26] Low Downgraded: inconsistency 3 studies |
| Adults with periodontitis and intrabony defects who completed active periodontal therapy and attended strict supportive periodontal care for at least 10 years | Guided tissue regeneration (GTR) in intrabony defects | Open flap debridement (OFD) or access flap | Clinical attachment level (CAL) 1 year · Supportive periodontal care after active periodontal therapy · Meta-analysis of studies comparing GTR and OFD | WMD -0.75 [-1.39, -0.12] GRADE not reported 3 studies |
| Adults with periodontitis who completed active periodontal therapy and attended supportive periodontal care (SPC) for at least 10 years | Guided tissue regeneration (GTR) | Open flap debridement (OFD) | Patient-reported outcome measures (PROMs) Unresolved: the two extractors disagree on this row. | None of the included studies reported on PROMs. No studies found 0 studies |
| Adults with periodontitis and intrabony defects who completed active periodontal therapy and attended strict supportive periodontal care for at least 10 years | Guided tissue regeneration (GTR) in intrabony defects | Open flap debridement (OFD) or access flap | Probing pocket depth (PPD) respective endpoints (10 to 20 years) · Supportive periodontal care after active periodontal therapy · Meta-analysis of studies comparing GTR and OFD | WMD -0.40 [-1.22, 0.41] Low Downgraded: inconsistency 3 studies |
| Adults with periodontitis and intrabony defects who completed active periodontal therapy and attended strict supportive periodontal care for at least 10 years | Guided tissue regeneration (GTR) in intrabony defects | Open flap debridement (OFD) or access flap | Probing pocket depth (PPD) respective endpoints (10 years) · Supportive periodontal care after active periodontal therapy · Sub-analysis of trials with 10-year SPC follow-up (Nickles 2009, Sculean 2008) | WMD 0.02 [-0.49, 0.52] GRADE not reported 2 studies |
| Adults with periodontitis and intrabony defects who completed active periodontal therapy and attended strict supportive periodontal care for at least 10 years | Guided tissue regeneration (GTR) in intrabony defects | Open flap debridement (OFD) or access flap | Probing pocket depth (PPD) baseline · Supportive periodontal care after active periodontal therapy · Sub-analysis of trials with 10-year SPC follow-up (Nickles 2009, Sculean 2008) | WMD -0.07 [-0.57, 0.44] GRADE not reported 2 studies |
| Adults with periodontitis and intrabony defects who completed active periodontal therapy and attended strict supportive periodontal care for at least 10 years | Guided tissue regeneration (GTR) in intrabony defects | Open flap debridement (OFD) or access flap | Clinical attachment level (CAL) 1 year · Supportive periodontal care after active periodontal therapy · Sub-analysis of trials with 10-year SPC follow-up (Nickles 2009, Sculean 2008) | WMD -0.57 [-1.39, 0.24] GRADE not reported 2 studies |
| Adults with periodontitis and intrabony defects who completed active periodontal therapy and attended strict supportive periodontal care for at least 10 years | Guided tissue regeneration (GTR) in intrabony defects | Open flap debridement (OFD) or access flap | Probing pocket depth (PPD) 1 year · Supportive periodontal care after active periodontal therapy · Sub-analysis of trials with 10-year SPC follow-up (Nickles 2009, Sculean 2008) | WMD -0.31 [-0.83, 0.20] GRADE not reported 2 studies |
| Adults with periodontitis and intrabony defects who completed active periodontal therapy and attended strict supportive periodontal care for at least 10 years | Guided tissue regeneration (GTR) in intrabony defects | Open flap debridement (OFD) or access flap | Clinical attachment level (CAL) respective endpoints (10 years) · Supportive periodontal care after active periodontal therapy · Sub-analysis of trials with 10-year SPC follow-up (Nickles 2009, Sculean 2008) | WMD -0.36 [-1.47, 0.74] GRADE not reported 2 studies |
Included primary studies 9
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Cortellini 2017 Periodontal regeneration compared with access flap surgery in human intra-bony defects 20-year follow-up of a randomized clinical trial:… PMID:27736011 | 2017 | this review only | Probing pocket depth (PPD); Clinical attachment level (CAL) | not extracted yet |
| Cortellini 2022 Modified minimally invasive surgical technique in human intrabony defects with or without regenerative materials-10-year follow-up of a… PMID:35415940 | 2022 | this review only | not stated | not extracted yet |
| Crespi 2011 Comparison of modified widman and coronally advanced flap surgery combined with Co2 laser root irradiation in periodontal therapy: a… PMID:22140666 | 2011 | this review only | not stated | not extracted yet |
| Dori 2013 Ten-year results following treatment of intrabony defects with an enamel matrix protein derivative combined with either a natural bone… PMID:22873657 | 2013 | this review only | not stated | not extracted yet |
| Nickles 2009 Open flap debridement and guided tissue regeneration after 10 years in infrabony defects. PMID:19807821 | 2009 | this review only | Probing pocket depth (PPD); Clinical attachment level (CAL) | not extracted yet |
| Nygaard-Ostby 2008 Periodontal healing following reconstructive surgery: effect of guided tissue regeneration using a bioresorbable barrier device when… PMID:18173400 | 2008 | this review only | not stated | not extracted yet |
| Petsos 2019 Infrabony defects 20 years after open flap debridement and guided tissue regeneration. PMID:30980561 | 2019 | this review only | Probing pocket depth (PPD); Clinical attachment level (CAL) | not extracted yet |
| Sculean 2008 Ten-year results following treatment of intra-bony defects with enamel matrix proteins and guided tissue regeneration. PMID:18647201 | 2008 | this review only | Probing pocket depth (PPD); Clinical attachment level (CAL) | not extracted yet |
| Serino 2001 Initial outcome and long-term effect of surgical and non-surgical treatment of advanced periodontal disease. PMID:11686808 | 2001 | this review only | not stated | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Adults with periodontitis (excluding systemic or necrotizing disease) who completed active periodontal therapy and attended supportive periodontal care for at least 10 years | Adults with periodontitis in SPC, 9 publications (8 RCTs; 3 trials in meta-analysis) |
| Intervention | Active periodontal therapy test arms of each RCT (non-surgical to regenerative surgery) | GTR, EMD, biomaterials, MWF, CAF with CO2 laser, SRP (n=9) |
| Comparison | Standard control intervention in each RCT | OFD, M-MIST, MWF, SRP, other regenerative materials (n=9) |
| Outcomes | Tooth loss (primary); PPD reduction, CAL gain, PROMs (secondary) | Tooth loss (n=4, not pooled); PPD (n=9; meta-analysis n=3); CAL (n=8; meta-analysis n=3); PROMs (n=0) |
| Study designs | RCTs | RCTs (n=9) |
| Timing | Minimum SPC follow-up of 10 years | 10 to 20 years of SPC |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | Yes | Yes | yes |
| 8Included studies described in detail | Yes | Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | NRSI: N/A · RCT: Yes | RCT: Yes | no |
| 10Funding of included studies reported | Yes | Yes | yes |
| 11Appropriate meta-analysis methodscritical | NRSI: N/A · RCT: Yes | RCT: No | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Low | Critically Low | no |