Healing Outcomes of Through-And-Through Bone Defects in Periapical Surgery: A Systematic Review and Meta-Analysis

Area of Science:

• Dentistry
• Oral Surgery
• Regenerative Medicine

Background:

• Through-and-through (TAT) cortical plate defects pose challenges in periapical surgery.
• Treatment outcomes for these defects are influenced by the surgical approach.

Purpose of the Study:

• To investigate if guided regenerative procedures (GRPs) enhance cortical plate healing in TAT lesions.
• To compare the overall treatment success of GRPs versus non-GRP treatments for TAT lesions.

Main Methods:

• Systematic literature search across major databases (PubMed, CINAHL Plus, Wiley Cochrane Library, Dental and Oral Science).
• Inclusion of studies on endodontically treated teeth with TAT lesions assessed by Cone Beam Computed Tomography.
• Risk of bias assessment using Cochrane Risk of Bias 2.0 and Newcastle-Ottawa Scale.

Main Results:

• Five studies met inclusion criteria; four were included in a meta-analysis.
• No significant difference in cortical plate healing between GRPs and non-GRPs (OR: 0.52, 95% CI: 0.12-2.39; p=0.40).
• No significant difference in overall treatment success between GRPs and non-GRPs (OR: 0.35, 95% CI: 0.09-1.39; p=0.14).

Conclusions:

• Guided regenerative procedures (GRPs) do not appear to significantly improve healing or treatment success in through-and-through (TAT) cortical plate defects.
• Further high-quality studies with larger sample sizes are necessary to confirm these findings and explore potential benefits.