Clinical performance of minimally invasive periodontal surgery in the treatment of infra-bony defects: systematic review and meta-analysis.

Abstract

AIM\nto assess the effectiveness, in terms of clinical performance and patient perception, of minimally invasive periodontal surgeries (MIPSs) and to compare MIPSs to traditional surgery in the treatment of periodontal infra-bony defects.\n\n\nMATERIALS AND METHODS\nan eletronic and a manual search were carried out to identify studies investigating clinical (CAL, PPD, REC), radiographic (bone fill) and patient s centered (VAS scale) outcomes at least 6 months after MIPSs. A Linear Mixed Effect Model was used for meta-analysis. Subgroup analyses were performed according to the study quality (RCT or case series). A meta-analysis assessing differences in clinical parameters between MIPSs and traditional flaps was also performed.\n\n\nRESULTS\nmeta-analysis from the 18 included studies revealed a PPD reduction of 4.24 mm (95% CI = 3.79 to 4.69 mm), a CAL gain of 3.89 mm (95% CI = 3.42 to 4.35 mm), a REC increase of 0.44 mm (95% CI = 0.11 to 0.77 mm), a radiographic bone fill gain of 58.25% (95% CI = 42.30% to 74.21%) and a VAS value of 1.16 (95% CI = 0.78 to 1.54). Based on 2 RCTs, MIPSs are more effective than traditional surgery for PPD reduction (0.93 mm., 95% CI = 1.71 to 0.15) and CAL gain (1 mm., 95% CI = 1.75 to 0.24).\n\n\nCONCLUSION\nMIPSs may be considered for treatment of periodontal infrabony defects. However, the real effect can not be systematically evaluated due to the paucity of studies comparing MIPSs to traditional flap for periodontal reconstructive surgery.