Section of Periodontology, Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy.
J Clin Periodontol. 2020 Jun;47(6):756-767. doi: 10.1111/jcpe.13281. Epub 2020 Mar 20.
To systemically review the available evidence on the clinical performance of osseous resective surgery (ORS) in the treatment of residual periodontal defects in terms of pocket elimination and biological costs in patients with chronic periodontitis.
Three databases (PubMed, EMBASE and Cochrane) were searched up to January 2019. Clinical trials with a follow-up duration of at least 12 months after ORS with or without fibre retention technique were included. Quantitative synthesis was conducted with random-effect meta-analysis.
Overall, 1,765 studies were retrieved, of which 53 full-text articles were screened by two reviewers. Finally, a total of three RCTs were included in the meta-analysis. Random-effect meta-analysis showed a weighted mean percentage of pocket elimination (final PD ≤ 4 mm) at 12 months of 98.3% (95% CI: 96.8; 99.7) with I of 26%. The weighted mean amount of resected bone was 0.87 mm (95% CI: 0.49; 1.25), and the weighted mean increase in gingival recession was 2.13 mm (95% CI: 1.49; 2.78) at 12 months.
ORS represents an effective surgical approach for the elimination of residual periodontal pockets in the short to medium term. Additional randomized controlled clinical trials with data on pocket elimination are warranted.
系统评价骨切除手术（ORS）治疗慢性牙周炎患者牙周残余缺损的临床疗效，主要评估牙周袋消除和生物学成本方面。
检索了三个数据库（PubMed、EMBASE 和 Cochrane），截至 2019 年 1 月，纳入 ORS 治疗后（或联合纤维保留技术）至少随访 12 个月的临床研究。采用随机效应荟萃分析进行定量综合分析。
共检索到 1765 项研究，其中 53 篇全文文章由两名审查员筛选。最终，共有 3 项 RCT 纳入荟萃分析。随机效应荟萃分析显示，12 个月时牙周袋消除的加权平均百分比（最终 PD≤4mm）为 98.3%（95%CI：96.8；99.7），I²为 26%。12 个月时，切除骨量的加权平均值为 0.87mm（95%CI：0.49；1.25），牙龈退缩的加权平均值为 2.13mm（95%CI：1.49；2.78）。
ORS 是一种有效的治疗方法，可在短至中期消除牙周袋残余缺损。需要更多的随机对照临床试验来提供关于牙周袋消除的数据。
