Accademia Toscana di Ricerca Odontostomatologica, Firenze, Italy.
J Evid Based Dent Pract. 2012 Sep;12(3 Suppl):89-100. doi: 10.1016/S1532-3382(12)70021-0.
A review of the current scientific literature was undertaken to evaluate the efficacy of minimally invasive periodontal regenerative surgery in the treatment of periodontal defects. The impact on clinical outcomes, surgical chair-time, side effects and patient morbidity were evaluated. An electronic search of PUBMED database from January 1987 to December 2011 was undertaken on dental journals using the key-word "minimally invasive surgery". Cohort studies, retrospective studies and randomized controlled clinical trials referring to treatment of periodontal defects with at least 6 months of follow-up were selected. Quality assessment of the selected studies was done through the Strength of Recommendation Taxonomy Grading (SORT) System. Ten studies (1 retrospective, 5 cohorts and 4 RCTs) were included. All the studies consistently support the efficacy of minimally invasive surgery in the treatment of periodontal defects in terms of clinical attachment level gain, probing pocket depth reduction and minimal gingival recession. Six studies reporting on side effects and patient morbidity consistently indicate very low levels of pain and discomfort during and after surgery resulting in a reduced intake of pain-killers and very limited interference with daily activities in the post-operative period. Minimally invasive surgery might be considered a true reality in the field of periodontal regeneration. The observed clinical improvements are consistently associated with very limited morbidity to the patient during the surgical procedure as well as in the post-operative period. Minimally invasive surgery, however, cannot be applied at all cases. A stepwise decisional algorithm should support clinicians in choosing the treatment approach.
对当前科学文献进行了回顾，以评估微创牙周再生手术治疗牙周缺损的疗效。评估了对临床结果、手术椅时间、副作用和患者发病率的影响。使用“微创手术”一词在 PUBMED 数据库中对牙科期刊进行了电子检索，检索时间从 1987 年 1 月到 2011 年 12 月。选择了至少有 6 个月随访期的涉及牙周缺损治疗的队列研究、回顾性研究和随机对照临床试验。通过推荐强度分类（SORT）系统对选定研究进行质量评估。纳入了 10 项研究（1 项回顾性研究、5 项队列研究和 4 项 RCT）。所有研究都一致支持微创牙周再生手术在治疗牙周缺损方面的疗效，在临床附着水平增加、探诊袋深度减少和牙龈退缩最小方面。有 6 项报告副作用和患者发病率的研究一致表明，手术期间和手术后疼痛和不适程度非常低，导致止痛药摄入量减少，术后日常生活活动受限非常有限。微创牙周再生手术可能是牙周再生领域的真正现实。观察到的临床改善与手术过程中和术后患者的发病率非常低有关。然而，微创牙周再生手术并不能应用于所有病例。逐步决策算法应支持临床医生选择治疗方法。
