Clinical performance of access flap in the treatment of class <scp>II</scp> furcation defects. A systematic review and meta‐analysis of randomized clinical trials

Graziani, Filippo; Gennai, Stefano; Karapetsa, Dimitra; Rosini, Stefano; Filice, Natalia; Gabriele, Mario; Tonetti, Maurizio S.

doi:10.1111/jcpe.12327

Cited by 33 publications

(26 citation statements)

References 67 publications

(86 reference statements)

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“…45 Whether this CAL gain is clinically superior to the CAL gain obtained after open flap debridement surgery 47 remains debatable; In fact, in a systematic review with meta-analysis, Graziani and colleagues reported that open flap debridement in the treatment of degree 2 FI resulted in 0.55 mm CAL gain. 47 We found that the location of the treated furcation defect was shown to be highly associated with CAL gain at 1 year (Table 4). It was observed that compared to the buccal furcation of mandibular molars, the mid-facial, disto-palatal, and mesio-palatal furcations of upper molars were significantly associated with lower levels of CAL gain.…”

Section: Discussionmentioning

confidence: 83%

Treatment effect of guided tissue regeneration on the horizontal and vertical components of furcation defects: A retrospective study

Majzoub

Barootchi

Tavelli

et al. 2020

Journal of Periodontology

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Background Identifying factors affecting the treatment outcomes of guided tissue regeneration (GTR) in furcation defects is imperative in order to obtain predictable regeneration outcomes. The aims of this study were to evaluate the clinical outcomes and survival of furcation‐involved teeth treated with GTR, and potential factors affecting the results. Methods Furcation defects treated with GTR using an allogeneic cancellous bone graft and covered by an absorbable membrane with at least 1‐year follow‐up were selected. All data relative to the clinical outcomes were recorded. Analyses were conducted to evaluate the immediate (1‐year post‐op) clinical outcomes and the long‐term (the last assessment time) survival of the treated teeth. The effect of variables on the 1‐year post‐op clinical attachment level (CAL) changes and the tooth survival were assessed via multi‐level regression analyses and Cox Proportional‐Hazards Models. Results Ninety‐eight treated defects were selected. The average follow‐up was 5.3 ± 4.3 years. At the 1‐year post‐surgical recall, 1.23 ± 1.48 mm CAL gain was observed (P < 0.05). The 5‐ and 10‐year survival rates of the treated teeth were 86.5% and 74.3%, respectively. The vertical component of the defect and the location of the furcation were significantly related to the post‐surgical 1‐year CAL gain, whereas membrane exposure significantly affected tooth survival. Conclusion Within the limitations of this study, data suggests GTR using allogeneic cancellous bone graft and absorbable collagen membrane to be a viable option for treating furcation‐involved teeth if the defect morphology and the location of the defect are favorable.

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Section: Discussionmentioning

confidence: 83%

Treatment effect of guided tissue regeneration on the horizontal and vertical components of furcation defects: A retrospective study

Majzoub

Barootchi

Tavelli

et al. 2020

Journal of Periodontology

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“…Open flap debridement produces less clinical improvement with furcation lesions, comprising less than 1 mm of horizontal attachment gain, than with other types of periodontal defects (Fig. ) . Tunnel treatment of furcation defects is best performed at teeth with short root trunks, severe intrafurcal bone loss and wide root divergence, but may give rise to soft tissue resection .…”

Section: Surgical Treatment Of Periodontitismentioning

confidence: 99%

Nonsurgical and surgical treatment of periodontitis: how many options for one disease?

Graziani¹,

Karapetsa²,

Alonso³

et al. 2017

Periodontology 2000

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325

232

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Treatment of periodontitis aims at preventing further disease progression with the intentions to reduce the risk of tooth loss, minimize symptoms and perception of the disease, possibly restore lost periodontal tissue and provide information on maintaining a healthy periodontium. Therapeutic intervention includes introduction of techniques to change behavior, such as: individually tailored oral-hygiene instructions; a smoking-cessation program; dietary adjustment; subgingival instrumentation to remove plaque and calculus; local and systemic pharmacotherapy; and various types of surgery. No single treatment option has shown superiority, and virtually all types of mechanical periodontal treatment benefit from adjunctive antimicrobial chemotherapy. Periodontal treatment, because of the chronic nature of periodontitis, is a lifelong commitment to intricate oral-hygiene techniques, which, when properly implemented, will minimize the risk of disease initiation and progression.

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“…The performance of the different flaps included within the conservative periodontal surgery classification regarding intrabony defects has been thoroughly studied in a recent systematic review and meta‐analysis . This review included 27 trials with 12 months of follow up reporting on 647 subjects and 734 intrabony defects.…”

Section: Performance Of Surgical Intervention On Residual Pocketsmentioning

confidence: 99%

“… as: class I when horizontal loss of periodontal tissue support is < 3 mm; class II when horizontal loss is > 3 mm without encompassing the total width of the furcation; and class III when a horizontal through‐and‐through destruction of the periodontal tissue is present. The performance of open flap debridement in the surgical treatment of class II mandibular furcation defects is the subject of another systematic review from our group . Eleven randomized clinical trials with a minimum of 6 months of follow up were assessed.…”

Section: Performance Of Surgical Intervention On Residual Pocketsmentioning

confidence: 99%

Surgical treatment of the residual periodontal pocket

Graziani¹,

Karapetsa²,

Mardas³

et al. 2017

Periodontology 2000

Self Cite

101

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The ultimate goal of periodontal therapy is to prevent further disease progression in order to reduce the risk of tooth loss. This objective can be achieved through a number of therapeutic modalities comprising both the nonsurgical and surgical phases of periodontal therapy. Nonsurgical periodontal treatment has been shown to control periodontal infection and to arrest progression of the disease in a significant number of cases. However, despite completion of nonsurgical treatment, a number of periodontal pockets, defined as 'residual', often remain. The presence of residual pockets may jeopardize tooth survival and be a risk factor of further disease progression, and ultimately tooth loss. Therefore, the aim of this review is to analyze the knowledge available on the indications for and the performance of periodontal surgical treatment of residual pockets in terms of 'traditional' (clinical, microbiological), patient-based and systemic health outcomes.

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Clinical performance of access flap in the treatment of class II furcation defects. A systematic review and meta‐analysis of randomized clinical trials

Abstract: Teeth with mandibular class II furcation involvement treated with OFD show significant clinical improvements 6 months after surgery. Nevertheless, in order to better understand the magnitude of these changes and their clinical relevance, prospective long-term trials are needed.

Cited by 33 publications

References 67 publications

Treatment effect of guided tissue regeneration on the horizontal and vertical components of furcation defects: A retrospective study

Treatment effect of guided tissue regeneration on the horizontal and vertical components of furcation defects: A retrospective study

Nonsurgical and surgical treatment of periodontitis: how many options for one disease?

Surgical treatment of the residual periodontal pocket

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