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The efficiency of the regeneration of periodontal intrabony defects in East Asians: A systematic review and pooled analysis. J Dent Sci 2023; 18:1-8. [PMID: 36643225 PMCID: PMC9831819 DOI: 10.1016/j.jds.2022.10.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 10/27/2022] [Indexed: 11/13/2022] Open
Abstract
This article aimed to assess the efficacy of periodontal regenerative therapy (PRT) for treating periodontal intrabony defects in East Asians. The systematic review was performed according to the PRISMA guidelines. Literature searches on the PubMed and national medical journal databases, and representative clinical journals of the East Asians were performed on July 31, 2018. Randomized controlled trials, prospective case-control studies, retrospective analyses, and case series receiving regenerative procedures, including barrier membrane (BM) and enamel matrix derivative (EMD) applications with or without bone replacement graft (BRG), with follow-up periods of 6 and 12 months were evaluated. The outcome variables were probing depth (PD) reduction and clinical attachment level (CAL) gain. Twenty studies were included, of which eight were assessed for bias risk. Compared to open flap debridement, PD reduction and CAL gain were superior in all PRTs at both follow-up time points. BM or EMD alone showed equivalent outcomes at 6 months, and CAL gain appeared greater with BM alone at 12 months. BM with BRG showed inferior CAL gain relative to BM alone, but EMD with BRG showed superior CAL gain relative to EMD alone at 12 months. In conclusion, PRT showed improved regenerative outcomes compared with OFD in East Asians, while BM application appeared less efficient than in non-East Asians. BRG supplementation provided additional clinical benefits in EMD application.
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Chen JT, Wu IT, Huang RY, Lin YC, Chou YH, Lin T, Kuo PJ, Tu CC, Hou LT, Lai YL, Lu HK, Tsai CC, Yuan K, Chen CJ, Ho CS, Yang YC, Wu AYJ, Huang KC, Chiang CY, Chang PC. Recommendations for treating stage I-III periodontitis in the Taiwanese population: A consensus report from the Taiwan Academy of Periodontology. J Formos Med Assoc 2021; 120:2072-2088. [PMID: 34294496 DOI: 10.1016/j.jfma.2021.06.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 06/16/2021] [Accepted: 06/29/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND/PURPOSE Based on the fundamental of the S3-level clinical practice guideline (CPG) for treating stage I-III periodontitis developed by the European Federation of Periodontology (EFP), this consensus report aimed to develop treatment recommendations for treating periodontitis in the Taiwanese population. METHODS The report was constructed by experts from the Taiwan Academy of Periodontology. The following topics were reviewed: (a) the prevalence of periodontitis in Asia and current status of treatment in Taiwan; (b) specific anatomical considerations for treating periodontitis in Asians; (d) educational and preventive interventions and supragingival plaque control; (d) subgingival instrumentation and adjunctive treatment; (e) surgical periodontal therapy; and (f) maintenance and supportive periodontal care. Recommendations were made according to the evidences from the EFP CPG, the published literature and clinical studies in Asians, and the expert opinions. RESULTS The treatment recommendations for the Taiwanese population were generally in parallel with the EFP CPG, and extra cautions during treatment and maintenance phases were advised due to the anatomical variations, such as shorter root trunk, higher prevalence of supernumerary distolingual root and lingual bony concavity in mandibular posteriors, and thinner anterior labial plate, of the Asian population. CONCLUSION The EFP CPG could be adopted for treating periodontitis and maintaining periodontal health of the Taiwanese population, and anatomical variations should be cautious when the treatment is delivered.
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Affiliation(s)
- Jung-Tsu Chen
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - I-Ting Wu
- Department of Dentistry, China Medical University Hospital, Taichung, Taiwan
| | - Ren-Yeong Huang
- School of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yi-Chun Lin
- Department of Dentistry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yu-Hsiang Chou
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Taichen Lin
- School of Dentistry, College of Oral Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Po-Jan Kuo
- School of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Che-Chang Tu
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Lein-Tuan Hou
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Lin Lai
- Department of Dentistry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hsein-Kun Lu
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chi-Cheng Tsai
- School of Dentistry, College of Oral Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Kuo Yuan
- Institute of Oral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chun-Jung Chen
- Department of Dentistry, Chi-Mei Medical Center, Tainan, Taiwan
| | | | - Yueh-Chao Yang
- Department of Dentistry, Cathay General Hospital, Taipei, Taiwan
| | - Aaron Yu-Jen Wu
- Department of Dentistry, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | | | - Cheng-Yang Chiang
- School of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Po-Chun Chang
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan.
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