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Published on: March 7, 2014
Cambios óseos radiográficos tras terapia periodontal no quirúrgica: una revisión sistemática y meta-análisis
T Lipovec1, M Shah2, Z Malaki2
1Periodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK; Interdisciplinary Doctoral Degree Programme Biomedicine, Clinical Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
Objective:
To evaluate radiographic alveolar bone changes following non-surgical periodontal therapy (NSPT).
Data:
This systematic review adhered to PRISMA guidelines and has been registered in PROSPERO (CRD42024564043). The Risk of Bias (RoB) was assessed using the RoB 2.0 tool for randomised trials and the Newcastle-Ottawa scale for non-randomised trials. Funnel plots were utilised to identify publication bias, and the level of certainty was evaluated using the GRADEpro Guideline Development Tool.
Sources:
Electronic (MEDLINE, Embase, Cochrane, VHL, Scopus) and manual searches.
Study Selection:
Studies published until 16 July 2024, reporting on radiographic changes after NSPT delivery with a follow-up duration of at least 6 months.
Results:
46 citations were included in the review. Single-arm meta-analysis evaluated infrabony defect depth reduction (DDR), defect fill (DF), defect angle fill (DAF), and horizontal bone loss (HBL). In non-minimally invasive non-surgical therapy (non-MINST) studies (22 studies, 631 subjects), infrabony DDR reached 0.18 mm and 0.13 mm, with DF ranging from 3.44 % to 2.70 % at 6 and 9-12 months, respectively. Class II furcation defects (5 studies, 144 subjects) exhibited DDR of 0.11-0.16 mm and DF of 2.87-3.44 % at respective time points. The lack of studies focusing on suprabony defects in non-MINST studies prevented their synthesis. MINST studies (4 studies, 144 subjects) presented more clinically significant improvements with effect increasing over 6-24 months: total DDR 1.48 mm, vertical DDR 1.64 mm, DF 29.17 %, DAF +7.03° High heterogeneity, high to unclear RoB, and low certainty of evidence were detected. Sensitivity analyses confirmed consistency, though heterogeneity remained high.
Conclusion:
The evidence suggests that NSPT may reduce radiographic defect depths, with MINST exhibiting more clinically significant results. Long-term, high-quality trials are needed to confirm these findings and inform clinical protocols.
Clinical Significance:
This systematic review suggests that non-surgical approaches can lead to measurable radiographic changes, indicating their potential to stimulate alveolar bone regeneration.
