The latest critical summary from the ADA-EBD Center considers a 2012 systematic review from Graziani et al. The aim of the review was to assess the effectiveness of conservative periodontal surgery (CS) for the treatment of periodontitis-related intrabony defects. Conservative periodontal surgery was defined as procedures that involved debridement of intrabony defects and root surfaces with no active removal of bone and often no resection of soft tissues done to reestablish periodontal health.
The summariser considered the review to be well conducted, including 30 studies representing 27 randomised controlled trials of at least 12 months duration. It was noted that publication bias was not assessed. Some concern was expressed about the decision to include 3 articles about the same population. There were also some concern regarding methodological quality of the studies and 11 of the included studies had a split-mouth design. As there was no significant heterogeneity the appraiser considered that this review suggests that,
conservative surgery may be an option for treating intrabony defects when regenerative treatment is not feasible.
Graziani F, Gennai S, Cei S, Cairo F, Baggiani A, Miccoli M, Gabriele M, Tonetti M. Clinical performance of access flap surgery in the treatment of the intrabony defect. A systematic review and meta-analysis of randomized clinical trials. J Clin Periodontol. 2012 Feb;39(2):145-56. doi: 10.1111/j.1600-051X.2011.01815.x. Epub 2011 Nov 27. Review. PubMed PMID: 22117895.