Minimally Invasive Surgical Technique in Periodontal Regeneration: A Randomized Controlled Clinical Trial Pilot Study

Ghezzi, Carlo; Ferrantino, Luca; Bernardini, Luigi; Lencioni, Margherita; Masiero, Silvia

doi:10.11607/prd.2550

Cited by 18 publications

(39 citation statements)

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“…The studies included a number of subjects ranging between 10 and 87. Only one study did not report the mean age of patients (Harrel, Wilson, & Nunn, ), while eleven did not report the age range of subjects (Aimetti et al, , Ghezzi et al, , Harrel et al, , Harrel, Wilson, & Nunn, , Harrel et al, , Ribeiro, Casarin, Palma, et al, 2011a, Ribeiro et al, , Ribeiro, Casarin, Palma, et al, 2011b, Ribeiro et al, , Schincaglia et al, , Trombelli et al, ). The overall age range of subjects analysed is 25–79 years.…”

Section: Resultsmentioning

confidence: 99%

“…Only Harrel et al () did not report information about gender. Regarding smokers status, three studies included light (<10/die) and former smokers (Cortellini et al, , Cortellini & Tonetti, , ; Cortellini et al, and Ghezzi et al, ). Other four included smokers (Trombelli et al, ; Trombelli et al, ; Trombelli et al, and Schincaglia et al, ).…”

Section: Resultsmentioning

confidence: 99%

“…The minimally invasive surgical technique (MIST) was used in eleven studies by different authors (Aimetti et al, ; Cortelini et al, ; Cortellini et al, ; Cortellini & Tonetti, , ; Cortellini & Tonetti, , ; Cosyn et al, ; De Bruyckere et al, ; Ghezzi et al, ; Ribeiro, Casarin, Palma, et al, 2011a; Ribeiro, Casarin, Palma, et al, 2011b; Ribeiro et al, , ), with the aid of an operating microscope. It consists of an envelope full‐thickness flap extended to the buccal and lingual aspects of the two teeth adjacent to the defect to expose 1–2 mm of the residual bone crest; flaps are then repositioned without any coronal displacement, and the suturing approach consists of a single modified internal mattress suture.…”

Section: Resultsmentioning

confidence: 99%

“…Regarding the use of grafts, these were tested in fourteen studies (Aimetti et al, , Cortellini et al, , Cortellini & Tonetti, , ; Cortellini et al, , Cortellini & Tonetti, , Cosyn et al, , De Bruyckere et al, , Ghezzi et al, , Harrel et al, , Ribeiro, Casarin, Palma, et al, 2011a, Ribeiro et al, , Schincaglia et al, , Trombelli et al, , Trombelli et al, ) (for details, see Table ).…”

Section: Resultsmentioning

confidence: 99%

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Clinical performance of minimally invasive periodontal surgery in the treatment of infrabony defects: Systematic review and meta‐analysis

Clementini

Ambrosi

Cicciarelli

et al. 2019

J Clinic Periodontology

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Aim To 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 infrabony defects. Materials and Methods An electronic search and a manual search were carried out to identify studies investigating clinical (CAL, PPD, REC), radiographic (bone fill) and patient's centred (VAS) 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. Results Meta‐analysis from the 18 included studies revealed a PPD reduction of 4.24 mm (95% CI = 3.79–4.69 mm), a CAL gain of 3.89 mm (95% CI = 3.42–4.35 mm), a REC increase of 0.44 mm (95% CI = 0.11–0.77 mm), a radiographic bone fill gain of 58.25% (95% CI = 42.30%–74.21%) and a VAS value of 1.16 (95% CI = 0.78–1.54). Based on 2 RCTs, MIPSs are more effective than traditional surgery for PPD reduction (0.93 mm, 95% CI = 1.71–0.15) and CAL gain (1 mm, 95% CI = 1.75–.24). Conclusion Minimally invasive periodontal surgeries may be considered for the treatment of periodontal infrabony defects. However, the real effect cannot be systematically evaluated due to the paucity of studies comparing MIPSs to traditional flap for periodontal reconstructive surgery.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Clinical performance of minimally invasive periodontal surgery in the treatment of infrabony defects: Systematic review and meta‐analysis

Clementini

Ambrosi

Cicciarelli

et al. 2019

J Clinic Periodontology

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“…The innovative aspects of the MIS technique are represented by a flap design [12–18] to permit preservation of interdental space, minimizing vertical release in order to obtain adhesion and maturation with slight trauma, together with primary intention wound closure to achieve periodontal tissue regeneration [11, 17–24]. …”

Section: Introductionmentioning

confidence: 99%

Ultrasonic Surgical Aspirator to Treat Deep Infrabony Defects: A New Flapless Minimally Invasive Approach

Ghezzi

Donghi

Ferrantino

et al. 2018

Advances in Medicine

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The primary outcome of the present study was to assess the percentage of pocket closure, and the secondary aim was to evaluate the clinical performance in terms of clinical attachment level (CAL) gain, probing pocket depth (PPD) reduction, and gingival recession (REC) after the use of cavitron ultrasonic surgical aspirator (CUSA) in deep infrabony defects. Fourteen deep infrabony defects in 11 patients who were previously treated with active periodontal therapy followed by one year of supportive periodontal therapy (at least three sessions) were additionally treated by the aid of CUSA. Eighty-six percent of the initial defects (12 out of 14) resulted in a PD < 5 mm, showing complete resolution six months after CUSA treatment, without any adverse event and with negligible pain (VAS from 0 to 3). CUSA showed potential as a method to promote pocket healing, reduce PPD, and increase clinical attachment (P < 0.001) in deep infrabony defects. This trial is registered with ClinicalTrials.gov NCT03567161.

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Efficacy of biologics for the treatment of periodontal infrabony defects: An American Academy of Periodontology best evidence systematic review and network meta‐analysis

Tavelli

Chen

Barootchi

et al. 2022

Journal of Periodontology

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Background: A large variety of biomaterials, biologics and membranes have been utilized in the past 40 years for the regenerative treatment of periodontal infrabony defects. Biologic agents have progressively gained popularity among clinicians and are routinely used for periodontal regeneration. In alignment with the goals of the American Academy of Periodontology (AAP) Best Evidence Consensus (BEC) on the use of biologic mediators in contemporary clinical practice, the aim of this sytematic review was to evaluate the effect of biologic agents, specifically autogenous blood-dervied products (ABPs), enamel matrix derivative (EMD) and recombinant human platelet-derived growth factor-BB (rhPDGF-BB), on the regenerative outcomes of infrabony defects. Methods: A detailed systematic search was conducted to identify eligible randomized control trials (RCTs) reporting the outcomes of periodontal regenerative therapy using biologics for the treatment of infrabony defects. A frequentist mixed-modeling approach to network meta-analysis (NMA), characterized by the assessment of three individual components for the treatment of an infrabony defect (the bone graft material [BG], the biologic agent, the application of a barrier membrane) was performed to evaluate and compare the relative efficacy of the different components, on the outcomes of different therapeutic modalities of periodontal regeneration. Results: A total of 153 eligible RCTs were included, with 150 studies contributing to the NMA. The quantitative analysis showed that the addition of biologic agents to bone graft significantly improves the clinical and radiographic outcomes, as compared to BG and flap procedures alone. Barrier membranes enhanced the regenerative outcomes of BG but did not provide further benefits in combination with biologics. The type of BG (autogenous, allogeneic, xenogeneic or alloplastic) and the biologic agent (EMD, platelet-rich fibrin [PRF], platelet-rich plasma [PRP] or rhPDGF-BB) played a significant role on the final outcomes of infrabony defects. Allogeneic and xenogeneic BGs exhibited statistically significantly superior clinical gain than synthetic and autogenous BGs (p < 0.05 in all the

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Minimally Invasive Surgical Technique in Periodontal Regeneration: A Randomized Controlled Clinical Trial Pilot Study

Cited by 18 publications

References 0 publications

Clinical performance of minimally invasive periodontal surgery in the treatment of infrabony defects: Systematic review and meta‐analysis

Clinical performance of minimally invasive periodontal surgery in the treatment of infrabony defects: Systematic review and meta‐analysis

Ultrasonic Surgical Aspirator to Treat Deep Infrabony Defects: A New Flapless Minimally Invasive Approach

Efficacy of biologics for the treatment of periodontal infrabony defects: An American Academy of Periodontology best evidence systematic review and network meta‐analysis

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