Systematic ReviewEffect of Guided Tissue Regeneration on the Outcome of Surgical Endodontic Treatment: A Systematic Review and Meta-analysis
Section snippets
Criteria for Considering Studies for This Review
This systematic review included clinical studies that reported the use of guided tissue regeneration in surgical endodontic treatment in patients with apical periodontitis in endodontically treated teeth.
The inclusion criteria included the following: (1) randomized clinical trials (RCTs), (2) a lesion location in the periapical area, (3) inclusion of GTR as a part of the surgical protocol (for the treatment group), (4) at least 1 year of follow-up, and (5) outcome evaluated according to Rud
Selection of Studies
The articles were initially evaluated for relevance based on their titles and abstracts by three observers independently (IT, AT, and ER). Possibly relevant studies were subject to a full text evaluation. The full texts of the studies were obtained and reviewed for suitability based on the inclusion and exclusion criteria of this meta-analysis. Cases of disagreement were discussed together until agreement was reached. Eventually, the identified suitable articles were subject to data extraction,
Results
The search in MEDLINE database using the PubMed search engine resulted in 168 articles, of which 11 6, 9, 10, 14, 15, 16, 18, 20, 21, 29, 30 were eligible for inclusion on the basis of their titles and abstracts and were subject to full-text evaluation. The other 157 articles were rejected based on the following: 23 were review articles, 24 were case reports, 4 were animal studies, and 106 articles were not relevant to the topic of the current study. The search with Scopus database resulted in
Discussion
GTR techniques have been suggested as an adjunct to endodontic surgery in order to promote bone healing 7, 8, 9, 10, 21. Several biomaterials were used as an osteoconductive scaffold in periapical surgery 10, 11, 12, 13, 14, 17, 22, 32, 33, 34, none of which achieved worldwide consensus. The aim of the present study was to search and evaluate the available literature concerning the influence of GTR on the outcome of surgical endodontic treatment by means of a systematic review of the literature
Conclusions
Based on the currently available data, GTR techniques may improve the outcome of bone regeneration after surgical endodontic treatment preformed in cases with certain periapical lesions, such as large periapical lesions, and through-and-through lesions. A favorable outcome is expected for using a resorbable membrane over a nonresorbable membrane or a graft alone. Large-scale prospective clinical studies are needed to further evaluate possible benefits of GTR techniques in endodontic surgery.
Acknowledgments
The authors deny any conflicts of interest related to this study.
References (47)
- et al.
Outcome of surgical endodontic treatment performed by a modern technique: a meta-analysis of literature
J Endod
(2009) - et al.
Modern endodontic surgery concepts and practice: a review
J Endod
(2006) - et al.
Retrospective evaluation of surgical endodontic treatment: traditional versus modern technique
J Endod
(2006) - et al.
Guided tissue regeneration in periapical surgery
J Endod
(2010) - et al.
Bone repair of experimentally induced through-and-through defects by Gore-Tex, Guidor, and Vicryl in ferrets: a pilot study
Oral Surg Oral Med Oral Pathol Oral Radiol Endod
(2001) - et al.
Effects of resorbable membrane placement and human osteogenic protein-1 on hard tissue healing after periradicular surgery in cats
J Endod
(1998) - et al.
The effect of calcium sulfate on hard-tissue healing after periradicular surgery
J Endod
(2004) - et al.
Histologic evaluation of a human periapical defect after implantation with tricalcium phosphate
Oral Surg Oral Med Oral Pathol
(1986) - et al.
An in vivo study of the use of a nonresorbable ceramic hydroxyapatite as an alloplastic graft material in periapical surgery
Oral Surg Oral Med Oral Pathol
(1991) - et al.
Periapical and periodontal healing after osseous grafting and guided tissue regeneration treatment of apicomarginal defects in periradicular surgery: results after 12 months
Oral Surg Oral Med Oral Pathol Oral Radiol Endod
(2003)