| Summary: | 碩士 === 臺北醫學大學 === 牙醫學系碩博士班 === 102 === Objective: The aim of this study was to systematically review the literature and to determine the clinical outcome of osseous resective surgery (OS) versus non-osseous resective flap surgery (NOS) on clinical attachment level (CAL) gain, probing periodontal depth (PPD) reduction, gingival recession (REC) gain and other periodontal parameters. Additionally, factors affecting clinical outcomes of OS were also identified.
Materials and Methods: An electronic search of the literature was conducted in the databases of MEDLINE OvidSP, PubMed, Cochrane, Scopus and Sciencedirect from January 1960 up to and including December 2013. Eligible studies were included in the systematic review if they met the following criteria: (1) randomized controlled clinical trial (RCT) (2) Human study (3) Patients with chronic periodontitis-related defects were performed with OS and NOS (4) studies showed at least 4-months of follow-up and included at least 7 subjects whose age ≥ 18. (5) Clinical parameters change [e.g., CAL gain, PPD reduction, REC increase, bony defect fill and bone crest reduction] were available to retrieve. (6) No language limitation. The exclusion criteria were: (1) Patients who use drugs or have systemic disease which involved in bone metabolism or periodontal inflammation (2) subjects diagnosed as aggressive periodontitis. Two investigators assessed the eligible publications independently.
Results: The search provided 725 articles of which eleven RCTs were included. Nine studies were respectively included for meta-analysis. Less CAL gain (WMD -0.30mm; 95% CI: -0.68, 0.07) and more PPD reduction (WMD 0.11mm; 95% CI: -0.22, 0.44) were noted in OS group than NOS group after 0.5-1 year follow-up. More REC gain (WMD 0.81mm; 95% CI: 0.20, 1.43) was also noted in OS group than in MWF alone group1 year after surgery. After 5-year follow-up, results still showed less CAL gain (WMD -0.22mm; 95% CI: -0.71, 0.27) and more PPD reduction (WMD 0.13mm; 95% CI: -1.37, 1.63) in OS group. There has not enough data for meta-analysis of hard tissue alteration after OS and NOS. However, a tendency of less periodontal defect fill and more crestal bone reduction was noted in OS group.
Conclusion: Treatment of periodontal defects with osseous resective surgery appears to be associated with improvement of periodontal clinical parameters and provides periodontal-related teeth with stable and promising prognosis.
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