Bioactive glass in the treatment of periodontal defects

shutterstock_19887505 - perio xrays

This aim of this review was to review to compile and synthesise the evidence on the use of bioactive glass (BG) as a graft material to treat infrabony defects caused by periodontal disease.

The authors searched PubMed, Embase, and Cochrane Database of Systematic Reviews as well as a manual search of recently published peridontology journals to identify randomized controlled trials (RCTs) of the use of BG in the treatment of intrabony and furcation defects.

Studies published in English with a follow up of ≥6 months with baseline and follow-up measures of probing depth (PD) and clinical attachment levels (CAL) with 95% confidence intervals, and an appropriate control arm were included. Data was extracted and cross-checked by at least two reviewers. Meta-analyses were performed for changes in PD and CAL between experimental and control groups, using the mean change plus SD for each study.

Of Twenty-five studies identified, 15 met the inclusion criteria; they found :-

  • that BG was superior to control for both measures: the mean (95% CI) difference from baseline to follow-up between BG and controls was 0.52 mm (0.27, 0.78, p<0.0001) in reduction for PD and 0.60 mm (0.18, 1.01, p=0.005) in gain for CAL.
  • Analyses of CAL revealed heterogeneity across studies (I2 = 60.5%), though studies reporting PD measures were homogenous (I2 = 0.00%). CAL heterogeneity appeared secondary to active controls versus open flap debridement (OFD) alone and to defect type modifying BG treatment success.
  • Per subgroup analyses, the benefit of BG over control treatment was highly significant only in studies comparing BG to OFD (p < 0.0001), with mean difference change in CAL being 1.18 mm (95% CI: 0.74, 1.62 mm) between the BG and OFD group.

They concluded

Treatment of intrabony defects with bioactive glass imparts a significant improvement in both probing depth and clinical attachment level in comparison with both active controls and OFD.

Sohrabi K, Saraiya  V, Laage  TA, Harris  M, Blieden  M, Karimbux N.An Evaluation of Bioactive Glass in the Treatment of Periodontal Defects: A Meta-Analysis of Randomized Controlled Clinical Trials. Journal of Periodontology Posted online on August 23, 2011. (doi:10.1902/jop.2011.110347)

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Derek Richards

Derek Richards is the Director of the Centre for Evidence-based Dentistry, Editor of the Evidence-based Dentistry Journal, Consultant in Dental Public Health with Forth Valley Health Board and Honorary Senior Lecturer at Dundee & Glasgow Dental Schools. He helped to establish both the Centre for Evidence-based Dentistry and the Evidence-based Dentistry Journal. He has been involved with teaching EBD and a wide range of evidence-based initiatives both nationally and internationally since 1994.

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