The efficacy of periodontal regenerative therapies, more challenges with network meta-analysis

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Mark-Steven Howe takes a detailed look at this review update and network meta-analyses of periodontal regenerative therapies. He highlights the inclusion of non-resorbable membrane studies that are no longer used.

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Periodontitis: Locally delivered anti-microbials as an adjunct to surgical periodontal treatment

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This review of the effectiveness of locally delivered adjunctive antibiotic treatment during periodontal surgery on clinical outcomes included 9 RCTs. While the findings suggested that adjunctive locally delivered antibiotics could improve some clinical sutcomes they evidence was limited and of very low certainty.

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Bone regeneration: Is cortical perforation a benefit?

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This review of the effect of cortical perforations in bone regeneration considering the surgical technique included 16 small studies. All but one of teh studies was conducted in an animal model providing very little clinically relevant data.

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Periodontal infrabony defects: does autologous platelet concentrates (APC) improve surgical outcomes

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38 RCTs were included in this Cochrane review of the effects of autologous platelet concentrates (APC) used as an adjunct to periodontal surgery. Very low quality evidence was found for two approaches involving open flap debridement.

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Gingival recession: which surgical treatment technique?

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This Cochrane review of the efficacy of different root coverage procedures for gingival recession included 48 RCTs describing a range of procedures. Most procedures led to a reduction in gingival recession.

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Periodontal regeneration therapies: Are benefits long-term?

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This review of periodontal regeneration therapies included 52 trials. While the results suggest some statistically significant improvements they may not be clinically important. There is also limited data for outcomes longer than 12 months.

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Third molar removal: effect on periodontal health of second mandibular molars

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Mark-Steven Howe looks in detail at a recent network meta-analysis (NMA) of periodontal outcomes following third molar surgery. However the limited number of studies available for the NMA mean the reviews findings need to be interpreted with caution.

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Alveolar ridge preservation techniques: evidence limited

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This review of alveolar ridge preservation techniques addressed two questions. They main one of benefit over unassisted healing only included 9 small studies of short duration providing limited evidence to support its use.

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Periapical surgery – improved outcomes with regenerative techniques?

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Eight small studies were identified for this review of the use of regenerative techniques as an adjunct to periapical surgery. The findings suggest that they improve outcomes after 1 year, but they should be interpreted with caution.

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Lasers for surgical periodontal treatment – insufficient evidence of effectiveness

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Eight small trials were identified for this review of lasers as an adjunct to surgical periodontal treatment. The limited number of studies and variation in the types of lasers used means there is insufficient evidence to support their effectiveness.

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