Clinical Efficacy of Minimally Invasive Surgical (MIS) and Non-surgical (MINST) Treatments of Periodontal Intra-bony Defect. A Systematic Review and Network Meta-analysis of RCT's

Overview

Journal Clin Oral Investig

Specialty Dentistry

Date 2020 Feb 14

PMID 32052179

Citations 12

Authors

Luigi Barbato

Filippo Selvaggi

Zamira Kalemaj

Jacopo Buti

Elena Bendinelli

Michele La Marca

Francesco Cairo

Affiliations

Soon will be listed here.

Abstract

Objective: The aim of this systematic review was to explore the efficacy of different minimal invasive surgical (MIS) and non-surgical (MINST) approaches for the treatment of intra-bony defect in terms of clinical attachment level (CAL) gain and periodontal pocket depth (PPD) reduction.

Methods: A detailed review protocol was designed according to PRISMA guideline. Online search was conducted on PubMed, Cochrane library and Embase. Only randomized clinical trials (RCTs) testing MIS or MINST procedure, with or without the application of a regenerative tool for the treatment of intra-bony defect, were included. Cochrane checklist for risk of bias assessment was used. Network meta-Analysis (NMAs) was used to rank the treatment efficacy.

Results: Nine RCTs accounting for 244 patients and a total of 244 defects were included. Only two studies were at low risk of bias. CAL gain for included treatment ranged from 2.58 ± 1.13 mm to 4.7 ± 2.5 mm while PPD reduction ranged from 3.19 ± 0.71 mm to 5.3 ± 1.5 mm. On the basis of the ranking curve, MINST showed the lowest probability to be the best treatment option for CAL gain. Pairwise comparisons and treatment rankings suggest superiority for regenerative approaches (CAL difference 0.78 mm, (0.14-1.41); P < 0.05) and surgical treatment elevating only the buccal or palatal flap (CAL difference: 0.95 mm, (0.33-1.57); P < 0.05).

Conclusions: Minimally invasive surgical (MIS) and non-surgical (MINST) periodontal therapy show promising results in the treatment of residual pocket with intra-bony defect.

Clinical Relevance: MIS procedures represent a reliable treatment for isolated intra-bony defect.

Citing Articles

A Comparison of the Treatment of Periodontal Infraosseous Defects with or Without Biomaterials by a Minimally Invasive Surgical Approach.

Gomez-Menchero A, Royon-Galvez M, Andres-Garcia R, Herrero-Climent M, Rios-Carrasco B, Fernandez-Palacin F J Clin Med. 2025; 14(4).

PMID: 40004641 PMC: 11856460. DOI: 10.3390/jcm14041111.

Non-Surgical Treatment of Moderate Periodontal Intrabony Defects With Adjunctive Cross-Linked Hyaluronic Acid: A Single-Blinded Randomized Controlled Clinical Trial.

Iorio-Siciliano V, Blasi A, Mauriello L, Salvi G, Ramaglia L, Sculean A J Clin Periodontol. 2024; 52(2):310-322.

PMID: 39402910 PMC: 11743238. DOI: 10.1111/jcpe.14078.

Treatment of Intrabony Defects with Non-Surgical Subgingival Debridement: A Radiographic Evaluation of Bone Gain Using an Experimental Digital Software "Bone Defect Analysis (BDA)".

Pardo A, Bonfante L, Signoriello A, Benetti A, Barillari M, Zanutto P J Clin Med. 2024; 13(15).

PMID: 39124582 PMC: 11313186. DOI: 10.3390/jcm13154315.

A novel periodontal endoscopy-aided non-incisional periodontal regeneration technique in the treatment of intrabony defects: a retrospective cohort study.

Shi J, Wang J, Yang Z, Li J, Lei L, Li H BMC Oral Health. 2023; 23(1):962.

PMID: 38044459 PMC: 10693706. DOI: 10.1186/s12903-023-03674-9.

A Systematic Review of Randomized Clinical Trials Evaluating the Efficacy of Minimally Invasive Surgery for Soft Tissue Management: Aesthetics, Postoperative Morbidity, and Clinical Results.

Ardila C, Gonzalez-Arroyave D, Vivares-Builes A Medicina (Kaunas). 2023; 59(5).

PMID: 37241156 PMC: 10223439. DOI: 10.3390/medicina59050924.

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