A systematic review and meta-analysis of guided tissue regeneration/osseous grafting for the treatment of Class II furcation defects

Background/purpose The purpose of this article was to conduct a systematic review of the clinical evidence on the efficacy of guide tissue regeneration (GTR) with/without osseous grafting (OG) in treating periodontal furcation Class II defects. Materials and methods Reports from randomized controlled clinical trials, with at least 6 months follow-up, comparing open flap debridement (OFD); GTR, and GTR + OG were located from various sources. Sources included the electronic databases of Cochrane Oral Health Group specialist trials register, MEDLINE, and PubMed; in addition, journal archives were hand-searched. Trials up to and including March 2012 were included. Using the PICO (Patient or Problem, Intervention, Comparison, and Outcome) question format, data from eligible articles were extracted and meta-analyzed. The outcomes measures were furcation closure rate, vertical/horizontal bone fill (re-entry), and vertical/horizontal attachment level gain. Results The meta-analysis showed that the GTR and GTR + OG groups obtained greater furcation closure rate, vertical/horizontal bone fill, and vertical/horizontal attachment level gain than the OFD group in mandibular molars. The GTR group obtained greater vertical/horizontal bone fill and vertical attachment level gain than the OFD group in maxillary molars. The GTR + OG group achieved better clinical outcomes than the GTR group did in all the comparing outcomes in mandibular molars. Conclusion GTR technique seemed to be more effective than OFD for resolving Class II periodontal furcation defects, and the GTR + OG technique showed even better clinical results. The outcomes were better for mandibular molars than for maxillary molars.