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Systematic review and sequential network meta-analysis on the efficacy of periodontal regenerative therapies.
J Clin Periodontol. 2020 Jun 27 [Online ahead of print]JC

Abstract

AIMS

We aimed to update a previous network meta-analysis comparing the efficacy of periodontal regenerative therapies on the treatment of infrabony lesions.

MATERIALS AND METHODS

Seven clinical trials were added after literature research for studies published between January 2011 and September 2019. We conducted network meta-analysis (NMA) to compare the effects of guided tissue regeneration (GTR), enamel matrix derivatives (EMD) and their combination therapies on probing pocket depth (PPD) reduction and clinical attachment level (CAL) gain. Sequential network meta-analysis (SNMA) was also used to control the type-I error rate due to multiple testing.

RESULTS

A total of 60 studies were included. For both PPD reduction and CAL gain, the flap operation (FO) was the least effective treatment. Although the differences between periodontal regenerative therapies were small, GTR attained the greatest reduction in PPD, and EMD with bone graft the greatest CAL gain compared to other therapies. SNMA used stricter efficacy criteria, yielding slightly different results from NMA.

CONCLUSIONS

EMD, GTR, and their combined therapies were more effective than flap operation, although the differences between regenerative therapies remain small in this updated study. SNMA reduces the risk of false-positive findings, thereby providing more robust evidence on the superiority of treatments.

Authors+Show Affiliations

Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan. Department of Medical Research, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan.Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan. Department of Medical Research, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan. Department of Dentistry, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32592595

Citation

Tsai, Shang-Jie, et al. "Systematic Review and Sequential Network Meta-analysis On the Efficacy of Periodontal Regenerative Therapies." Journal of Clinical Periodontology, 2020.
Tsai SJ, Ding YW, Shih MC, et al. Systematic review and sequential network meta-analysis on the efficacy of periodontal regenerative therapies. J Clin Periodontol. 2020.
Tsai, S. J., Ding, Y. W., Shih, M. C., & Tu, Y. K. (2020). Systematic review and sequential network meta-analysis on the efficacy of periodontal regenerative therapies. Journal of Clinical Periodontology. https://doi.org/10.1111/jcpe.13338
Tsai SJ, et al. Systematic Review and Sequential Network Meta-analysis On the Efficacy of Periodontal Regenerative Therapies. J Clin Periodontol. 2020 Jun 27; PubMed PMID: 32592595.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Systematic review and sequential network meta-analysis on the efficacy of periodontal regenerative therapies. AU - Tsai,Shang-Jie, AU - Ding,Yu-Wei, AU - Shih,Ming-Chieh, AU - Tu,Yu-Kang, Y1 - 2020/06/27/ PY - 2020/01/10/received PY - 2020/05/21/revised PY - 2020/06/20/accepted PY - 2020/6/28/pubmed PY - 2020/6/28/medline PY - 2020/6/28/entrez KW - enamel matrix derivatives KW - guided tissue regeneration KW - network meta-analysis KW - periodontal regenerative therapies KW - sequential network meta-analysis KW - trial sequential analysis JF - Journal of clinical periodontology JO - J. Clin. Periodontol. N2 - AIMS: We aimed to update a previous network meta-analysis comparing the efficacy of periodontal regenerative therapies on the treatment of infrabony lesions. MATERIALS AND METHODS: Seven clinical trials were added after literature research for studies published between January 2011 and September 2019. We conducted network meta-analysis (NMA) to compare the effects of guided tissue regeneration (GTR), enamel matrix derivatives (EMD) and their combination therapies on probing pocket depth (PPD) reduction and clinical attachment level (CAL) gain. Sequential network meta-analysis (SNMA) was also used to control the type-I error rate due to multiple testing. RESULTS: A total of 60 studies were included. For both PPD reduction and CAL gain, the flap operation (FO) was the least effective treatment. Although the differences between periodontal regenerative therapies were small, GTR attained the greatest reduction in PPD, and EMD with bone graft the greatest CAL gain compared to other therapies. SNMA used stricter efficacy criteria, yielding slightly different results from NMA. CONCLUSIONS: EMD, GTR, and their combined therapies were more effective than flap operation, although the differences between regenerative therapies remain small in this updated study. SNMA reduces the risk of false-positive findings, thereby providing more robust evidence on the superiority of treatments. SN - 1600-051X UR - https://www.unboundmedicine.com/medline/citation/32592595/Systematic_Review_and_Sequential_Network_Meta-Analysis_on_the_Efficacy_of_Periodontal_Regenerative_Therapies L2 - https://doi.org/10.1111/jcpe.13338 DB - PRIME DP - Unbound Medicine ER -
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