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

Through-and-through (TAT) cortical plate defects present a challenge in periapical surgery, influencing treatment outcomes. This study investigates whether guided regenerative procedures (GRPs) enhance cortical plate healing and overall success compared to non-GRP treatments in TAT lesions. A systematic search was conducted across PubMed, CINAHL Plus, Wiley Cochrane Library, and Dental and Oral Science. Studies assessing endodontically treated teeth with TAT lesions via Cone Beam Computed Tomography were included. The risk of bias was assessed using Cochrane Risk of Bias 2.0 tool and Newcastle-Ottawa Scale. Five studies met inclusion criteria, with four included in meta-analysis. No significant differences were observed in cortical plate healing (OR: 0.52, 95% CI: 0.12-2.39; p = 0.40) or treatment success (OR: 0.35, 95% CI: 0.09-1.39; p = 0.14) between GRPs and non-GRPs. Findings suggest that GRPs do not significantly improve healing in TAT lesions, highlighting the need for further studies with larger sample sizes.