Journal of clinical periodontology · 2026
Efficacy of Biologics for Surgical Treatment of Periodontal Suprabony Defects: A Systematic Review and Meta-Analysis of Controlled Clinical Trials.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод пока не подготовлен
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Baniameri Sahar, Hazrati Parham, Sabri Hamoun, Alrmali Abdusalam E, Parma-Benfenati Lucrezia, ElRefaei Saeed A, Wang Hom-Lay, Saleh Muhammad H A
Аннотация
AIM: Limited bone support in suprabony defects hinders predictable regeneration, but adjunctive biologics can improve results. This systematic review and meta-analysis aimed to evaluate the clinical efficacy of adjunctive biologics combined with open flap debridement (OFD) compared with OFD alone when treating suprabony defects.
MATERIALS AND METHODS: A systematic literature search was performed to identify controlled trials evaluating adult patients presenting horizontal periodontal defects. The primary outcome included residual probing depth (PD). Random-effects meta-analyses were performed; heterogeneity was assessed using I 2 statistics; risk of bias was evaluated using Cochrane RoB-2; and evidence of quality was appraised via the GRADE framework.
RESULTS: Nine studies comprising 303 patients were included. Adjunctive use of biologics-including enamel matrix derivative (EMD), platelet-rich fibrin (PRF) and hyaluronic acid (HA)-significantly enhanced clinical outcomes compared to OFD alone, with pooled mean differences favouring EMD and PRF for both residual PD (-0.89 and -0.42 mm) and clinical attachment level (CAL) (-1.32 and -0.69 mm). While subgroup differences were observed, notably with EMD, high heterogeneity was present for CAL and PD, and evidence of certainty ranged from low to very low.
CONCLUSION: Adjunctive biologics improve clinical outcomes in suprabony periodontal defects; however, rigorous standardised trials are needed for reaching firm conclusions.
MATERIALS AND METHODS: A systematic literature search was performed to identify controlled trials evaluating adult patients presenting horizontal periodontal defects. The primary outcome included residual probing depth (PD). Random-effects meta-analyses were performed; heterogeneity was assessed using I 2 statistics; risk of bias was evaluated using Cochrane RoB-2; and evidence of quality was appraised via the GRADE framework.
RESULTS: Nine studies comprising 303 patients were included. Adjunctive use of biologics-including enamel matrix derivative (EMD), platelet-rich fibrin (PRF) and hyaluronic acid (HA)-significantly enhanced clinical outcomes compared to OFD alone, with pooled mean differences favouring EMD and PRF for both residual PD (-0.89 and -0.42 mm) and clinical attachment level (CAL) (-1.32 and -0.69 mm). While subgroup differences were observed, notably with EMD, high heterogeneity was present for CAL and PD, and evidence of certainty ranged from low to very low.
CONCLUSION: Adjunctive biologics improve clinical outcomes in suprabony periodontal defects; however, rigorous standardised trials are needed for reaching firm conclusions.