Efficacy of treatment of class II furcation lesions using membrane associated with bone grafting in mandibular molars compared to membrane only: a systematic review and meta-analysis.
Abstract
Objective: The objective of the present systematic review and meta-analysis was to compare treatment with membrane associated with bone grafting and treatment exclusively with membrane in the approach of Class II furcation defects in mandibular molars.
Materials and Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analyses statement was followed. Searches were conducted in five databases (PubMed, Web of Science, Scopus, Ovid, and Lilacs), in Septem-ber 2021, without restriction regarding publication year or language. Studies comparing membranes associated with bone grafting and membranes exclusively in the treatment of Class II furcation lesions were included. Cross-sectional, case-control studies, and reviews were excluded. Study selection, data extraction, and risk of bias assessment (MINORS) were performed by two review authors. The certainty of the evidence (GRADE) was evaluated and meta-analysis was performed. Mean difference (MD) and 95% confidence interval (CI) were provided.
Results: Four hundred eighty-six references were iden-tified and four studies were included. Greater reduction in probing depth [MD = 0.32 (CI = 0.09, 0.56)] and greater clinical attachment level gain [MD = 0.41 (CI = 0.24, 0.57)] were observed when membrane and bone grafting were used. The risk of bias of included studies was low.
Conclusions: This present systematic review and meta-analysis demonstrated that treatment of Class II furcation defects in mandibular molars using membrane and bone grafing is significantly more efficacious than treatment with the exclusive use of membrane.
Keywords: Periodontitis; Bone grafting; Membranes; Guided tissue regeneration; Furcation defects; Systematic review
References
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[41]. Nibali L, Shemie M, Li G, Ting R, Asimakopoulou K, Barbagallo G, Lee R, Eickholz P, Kocher T, Walter C, Aimetti M, Rüdiger S. Periodontal furcation lesions: A survey of diagnosis and management by general dental practitioners. J Clin Periodontol. 2021;48(11):1441-1448. doi: 10.1111/jcpe.13543. Epub 2021 Sep 21. PMID: 34472119.
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[3]. Nibali L, Shemie M, Li G, Ting R, Asimakopoulou K, Barbagallo G, Lee R, Eickholz P, Kocher T, Walter C, Aimetti M, Rüdiger S. Periodontal furcation lesions: A survey of diagnosis and management by general dental practitioners. J Clin Periodontol. 2021;48(11):1441-1448. doi: 10.1111/jcpe.13543. Epub 2021 Sep 21. PMID: 34472119.
[4]. Lasserre JF, Brecx MC, Toma S. Oral Microbes, Biofilms and Their Role in Periodontal and Peri-Implant Diseases. Materials. 2018;11(10):1802.
[5]. Shrivastava D, Natoli V, Srivastava KC, Alzoubi IA, Nagy AI, Hamza MO, Al-Johani K, Alam MK, Khurshid Z. Novel Approach to Dental Biofilm Management through Guided Biofilm Therapy (GBT): A Review. Microorganisms. 2021;9(9):1966. doi: 10.3390/microorganisms9091966. PMID: 34 576863; PMCID: PMC8468826.
[6]. Mensi M, Scotti E, Sordillo A, Agosti R, Calza S. Plaque disclosing agent as a guide for professional biofilm removal: A randomized controlled clinical trial. Int J Dent Hyg. 2020;18(3):285–94.
[7]. Dommisch H, Walter C, Dannewitz B, Eickholz P. Resective surgery for the treatment of furcation involvement: A systematic review. J Clin Periodontol. 2020;47(S2):375–91.
[8]. Jepsen S, Gennai S, Hirschfeld J, Kalemaj Z, Buti J, Graziani F. Regenerative surgical treatment of furcation defects: A systematic review and Bayesian network meta-analysis of randomized clinical trials. J Clin Periodontol. 2020;47(S2):352–74.
[9]. Dorj O, Lee WF, Salamanca E, Pan YH, Wu YF, Hsu YS, Lin JCY, Lin YD, Choy CS, Chang WJ. Guided Tissue Regeneration Treatment Yields Better Results in Class II Furcations in the Mandible Than in the Maxilla: A Retrospective Study. Int J Environ Res Public Health. 2021;18(14):7447. doi: 10.3390/ijerph18147447. PMID: 34299898; PMCID: PMC8303943.
[10]. Friedmann A, Stavropoulos A, Bilhan H. GTR Treatment in Furcation Grade II Periodontal Defects with the Recently Reintroduced Guidor PLA Matrix Barrier: A Case Series with Chronological Step-by-Step Illustrations. Case Rep Dent. 2020; 16(2020):8856049.
[11]. Seidel M, Borenius H, Schorr S, Christofzik D, Graetz C. Results of an experimental study of subgingival cleaning effectiveness in the furcation area. BMC Oral Health. 2021;21(1):381.
[12]. Majzoub J, Salami A, Barootchi S, Tavelli L, Wang H-L, Chan H-L. Multivariate outcome evaluation of furcation-involved molars treated with non-surgical mechanical therapy alone or combined with open flap debridement: A retrospective study. J Periodontol. 2022;93(5):673-686.
[13]. Bevilacqua L, Fonzar A, Olivier S, De Biasi M, Visintin M, Angerame D, Maglione M. Outcome of Different Surgical Approaches in the Treatment of Class II Furcation Defects in Mandibular Molars: a Randomized Clinical Trial. Int J Periodontics Restorative Dent. 2020;40(5):693-701.
[14]. Gill T, Bahal P, Nibali L. Furcation-involved molar teeth-part 2: management and prognosis. Br Dent J. 2022;233(11):923-28.
[15]. Soares DM, de Melo JGA, Barboza CAG, Alves R de V. The use of enamel matrix derivative in the treatment of class II furcation defects: systematic review and meta-analysis. Aust Dent J. 2020;65(4):241–51.
[16]. Mocanu R, Martu S. Types of Barrier-Membrane in Periodontal Therapy of Guided Tissue Regeneration. Rom J Med Dent Educ. 2019;8(10):6–12.
[17]. Mansour AM, Yahia S, Elsayed HRH, El-Attar SAE, Grawish ME, El-Hawary YM, El-Sherbiny IM. Efficacy of biocompatible trilayers nanofibrous scaffold with/without allogeneic adipose-derived stem cells on class II furcation defects of dogs’ model. Clin Oral Investig. 2022;26(3):2537-2553. doi: 10.1007/s00784-021-04222-x. Epub 2021 Oct 18. PMID: 34661742.
[18]. Chaudhari A, Borse H, Mali A, Agrawal P, Landge N, Khadtare Y. Guide the tissues for periodontal regeneration (GTR): a review. Int J Curr Res. 2017;9(10):59269–78.
[19]. Tavelli L, Barootchi S, Rasperini G, Giannobile WV. Clinical and patient-reported outcomes of tissue engineering strategies for periodontal and peri-implant reconstruction. Periodontol 2000. 2023;91(1):217-269.
[20]. Swami RK, Kolte AP, Bodhare GH, Kolte RA. Bone replacement grafts with guided tissue regeneration in treatment of grade II furcation defects: a systematic review and meta-analysis. Clin Oral Investig. 2021;25(3):807–21.
[21]. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hróbjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S, McGuinness LA, Stewart LA, Thomas J, Tricco AC, Welch VA, Whiting P, Moher D. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. J Clin Epidemiol. 2021;134:178-189. doi: 10.1016/j.jcli nepi.2021.03.001. Epub 2021 Mar 29. PMID: 33789819.
[22]. Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J. Methodological index for non-randomized studies (Minors): Development and validation of a new instrument. ANZ J Surg. 2003;73(9):712–6.
[23]. Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2nd ed. Hillsdale: NJ Lawrence Erlbaum Associates; 1988.
[24]. Guyatt G, Oxman AD, Akl EA, Kunz R, Vist G, Brozek J, Norris S, Falck-Ytter Y, Glasziou P, DeBeer H, Jaeschke R, Rind D, Meerpohl J, Dahm P, Schünemann HJ. GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol. 2011;64(4):383-94. doi: 10.1016/j.jclinepi.2010.04.026. Epub 2010 Dec 31. PMID: 21195583.
[25]. Luepke PG, Luepke PG MJT, Brunsvold MA, Luepke PG, Luepke PG MJT, Brunsvold MA. A clinical evaluation of a bioresorbable barrier with and without decalcified freeze-dried bone allograft in the treatment of molar furcations. J Clin Periodontol. 1997;24(6):440–6.
[26]. Maragos P, Bissada NF, Wang R, Cole BP. Comparison of Three Methods Using Calcium Sulfate as a Graft/Barrier Material for the Treatment of Class II Mandibular Molar Furcation Defects. Int J Periodontics Restor Dent. 2002;22(5):493–501.
[27]. Hazzaa HH, El Adawy H, Magdi HM, Hazzaa HH EAH, Magdi HM. A Novel Surgical Approach for Treatment of Class II Furcation Defects Using Marginal Periosteal Membrane. J Int Acad Periodontol. 2015;17(1):20–31.
[28]. Lekovic V KEBCFaj, Danilovic V, Lekovic V, Kenney EB, Carranza FAJ, Danilovic V. Treatment of class II furcation defects using porous hydroxylapatite in conjunction with a polytetrafluoroethylene membrane. J Periodontol. 1990 Sep;61(9):575–8.
[29]. Taheri M, Molla R, Radvar M, Sohrabi K, Najafi MH. An evaluation of bovine derived xenograft with and without a bioabsorbable collagen membrane in the treatment of mandibular Class II furcation defects. Aust Dent J. 2009;54(3):220-7.
[30]. Kini V, Nayak DG, Uppoor AS. A Clinical Evaluation of Biphasic Calcium Phosphate Alloplast with and without a Flowable Bioabsorbable Guided Tissue Regeneration Barrier in the Treatment of Mandibular Molar Class II Furcation Defects. J Contemp Dent Pract. 2016;17(2):143-8. doi: 10.5005/jp-journals-10024-1817. PMID: 27207003.
[31]. Rani N, Kaushal S, Singh S, Nandlal, Khan MA, Pathak AK. Evaluation of the relative efficacy of autologous platelet-rich fibrin membrane in combination with β-tricalcium phosphate (Septodont-resorbable tissue replacement)TM alloplast versus β-TCP alloplast alone in the treatment of grade II furcation defects. Natl J Maxillofac Surg. 2018;9(2):196–204.
[32]. Li F, Qiao J, Duan JY, Zhang Y, Wang XJ. Effect of concentrated growth factors combined with guided tissue regeneration in treatment of classII furcation involvements of mandibular molars. Beijing Da Xue Xue Bao. 2020;52(2):346–52.
[33]. Queiroz LA, Santamaria MP, Casati MZ, Ruiz KS, Nociti F Jr, Sallum AW, Sallum EA. Enamel matrix protein derivative and/or synthetic bone substitute for the treatment of mandibular class II buccal furcation defects. A 12-month randomized clinical trial. Clin Oral Investig. 2016;20(7):1597-606. doi: 10.1007/s00784-015-1642-x. Epub 2015 Nov 10. PMID: 26556577.
[34]. Rasperini G, Majzoub J, Tavelli L, Limiroli E, Katayama A, Barootchi S, Hill R, Wang HL. Management of Furcation-Involved Molars: Recommendation for Treatment and Regeneration. Int J Periodontics Restorative Dent. 2020;40(4):e137-e146. doi: 10.11607/prd.4341. PMID: 32559031.
[35]. Dannewitz B, Krieger JK, Hüsing J, Eickholz P. Loss of molars in periodontally treated patients: A retrospective analysis five years or more after active periodontal treatment. J Clin Periodontol. 2006;33(1):53–61.
[36]. Carnevale G, Pontoriero R, di Febo G. Long-term effects of root-resective therapy in furcation-involved molars. A 10-year longitudinal study. J Clin Periodontol. 1998;25(3):209–14.
[37]. Eickholz P, Hausmann E. Evidence for healing of periodontal defects 5 years after conventional and regenerative therapy: digital subtraction and bone level measurements. J Clin Periodontol. 2002;29(10):922–8.
[38]. Majzoub J, Barootchi S, Tavelli L, Wang C-W, Travan S, Wang H-L. Treatment effect of guided tissue regeneration on the horizontal and vertical components of furcation defects: A retrospective study. J Periodontol. 2020;91(9):1148–58.
[39]. Cattabriga M, Pedrazzoli V, Wilson TG. The conservative approach in the treatment of furcation lesions. Periodontol 2000. 2000;22(1):133–53.
[40]. Oliveira HFE, Verri F, Lemos CA, Cruz R, Batista VES, Pellizzer E, Santinoni C. Clinical Evidence for Treatment of Class II Periodontal Furcation Defects. Systematic Review and Meta-analysis. J Int Acad Periodontol. 2020;22(3):117-128.
[41]. Nibali L, Shemie M, Li G, Ting R, Asimakopoulou K, Barbagallo G, Lee R, Eickholz P, Kocher T, Walter C, Aimetti M, Rüdiger S. Periodontal furcation lesions: A survey of diagnosis and management by general dental practitioners. J Clin Periodontol. 2021;48(11):1441-1448. doi: 10.1111/jcpe.13543. Epub 2021 Sep 21. PMID: 34472119.
[42]. Costa FO, Cortelli JR, Cortelli SC, Costa AA, Esteves Lima RP, Costa AM, Pereira GHM, Cota LOM. The loss of molars in supportive periodontal care: A 10-year follow-up for tooth- and patient-related factors. J Clin Periodontol. 2022;49(3):292-300.
[43]. Bandeira de Almeida A, Prado Maia L, Demoner Ramos U, Luís Scombatti de Souza S, Bazan Palioto D. Success, survival and failure rates of dental implants: a cross-sectional study. J Oral Sci Rehabil J Oral Sci Rehabil J Oral Sci Rehabil. 2017;243(2):24–31.
[44]. Ferreira SD, Martins CC, Amaral SA, Vieira TR, Albuquerque BN, Cota LOM, Esteves Lima RP, Costa FO. Periodontitis as a risk factor for peri-implantitis: Systematic review and meta-analysis of observational studies. J Dent. 2018;79:1-10.
[45]. Dreyer H, Grischke J, Tiede C, Eberhard J, Schweitzer A, Toikkanen SE, Glöckner S, Krause G, Stiesch M. Epidemiology and risk factors of peri-implantitis: A systematic review. J Periodontal Res. 2018;53(5):657-681. doi: 10.1111/jre.12562. Epub 2018 Jun 7. PMID: 29882313.
[46]. Schwarz F, Derks J, Monje A, Wang H-L. Peri-im-plantitis. J Clin Periodontol. 2018;45(S20):S246–66.
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Published
2023-10-14
How to Cite
LIMA COSTA BARCELOS, Giovanna et al.
Efficacy of treatment of class II furcation lesions using membrane associated with bone grafting in mandibular molars compared to membrane only: a systematic review and meta-analysis..
Journal of Oral Research, [S.l.], v. 12, n. 1, p. 152-168, oct. 2023.
ISSN 0719-2479.
Available at: <https://joralres.com/index.php/JOralRes/article/view/joralres.2023.014>. Date accessed: 02 may 2024.
doi: https://doi.org/10.17126/joralres.2023.014.
Issue
Section
Reviews
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