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De Lauretis A, Øvrebø Ø, Romandini M, Lyngstadaas SP, Rossi F, Haugen HJ. From Basic Science to Clinical Practice: A Review of Current Periodontal/Mucogingival Regenerative Biomaterials. Adv Sci (Weinh) 2024; 11:e2308848. [PMID: 38380549 PMCID: PMC11077667 DOI: 10.1002/advs.202308848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 01/23/2024] [Indexed: 02/22/2024]
Abstract
Periodontitis is a dysbiosis-driven inflammatory disease affecting the tooth-supporting tissues, characterized by their progressive resorption, which can ultimately lead to tooth loss. A step-wise therapeutic approach is employed for periodontitis. After an initial behavioral and non-surgical phase, intra-bony or furcation defects may be amenable to regenerative procedures. This review discusses the regenerative technologies employed for periodontal regeneration, highlighting the current limitations and future research areas. The search, performed on the MEDLINE database, has identified the available biomaterials, including biologicals (autologous platelet concentrates, hydrogels), bone grafts (pure or putty), and membranes. Biologicals and bone grafts have been critically analyzed in terms of composition, mechanism of action, and clinical applications. Although a certain degree of periodontal regeneration is predictable in intra-bony and class II furcation defects, complete defect closure is hardly achieved. Moreover, treating class III furcation defects remains challenging. The key properties required for functional regeneration are discussed, and none of the commercially available biomaterials possess all the ideal characteristics. Therefore, research is needed to promote the advancement of more effective and targeted regenerative therapies for periodontitis. Lastly, improving the design and reporting of clinical studies is suggested by strictly adhering to the Consolidated Standards of Reporting Trials (CONSORT) 2010 statement.
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Affiliation(s)
- Angela De Lauretis
- Department of Biomaterials, Institute of Clinical Dentistry, Faculty of DentistryUniversity of OsloOslo0455Norway
- Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”Politecnico di MilanoMilan20133Italy
| | - Øystein Øvrebø
- Department of Biomaterials, Institute of Clinical Dentistry, Faculty of DentistryUniversity of OsloOslo0455Norway
- Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”Politecnico di MilanoMilan20133Italy
| | - Mario Romandini
- Department of Periodontology, Institute of Clinical Dentistry, Faculty of DentistryUniversity of OsloOslo0455Norway
| | - Ståle Petter Lyngstadaas
- Department of Biomaterials, Institute of Clinical Dentistry, Faculty of DentistryUniversity of OsloOslo0455Norway
| | - Filippo Rossi
- Department of Chemistry, Materials and Chemical Engineering “Giulio Natta”Politecnico di MilanoMilan20133Italy
| | - Håvard Jostein Haugen
- Department of Biomaterials, Institute of Clinical Dentistry, Faculty of DentistryUniversity of OsloOslo0455Norway
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Elboraey MO, Mously EA. Clinical and Radiographic Evaluation of Third-Generation Pericardium Membrane for the Treatment of Grade II Furcation Defect in Stage III Periodontitis Patients. Medicina (B Aires) 2023; 59:medicina59030572. [PMID: 36984573 PMCID: PMC10059014 DOI: 10.3390/medicina59030572] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/04/2023] [Accepted: 03/13/2023] [Indexed: 03/17/2023] Open
Abstract
Background and Objectives: Guided tissue regeneration, with or without a bone graft, is a modality for the treatment of furcation involvement. Because the direct application of a bone graft into the periodontal defect has drawbacks, such as the risk of microbial contamination and/or graft containment, a new modality of directly loading bone graft particles over the barrier membrane is now used. This study aimed to evaluate clinically and radiographically the effects of a two-layered membrane consisting of a layer of nanohydroxyapatite particles on a pericardium membrane in the treatment of stage III periodontitis, compared with direct application of a nanohydroxyapatite bone graft. Materials and Methods: Forty individuals with grade II furcation involvement were divided into two groups. Group I was treated with a two-layered membrane consisting of a pericardium membrane with nanohydroxy particles loaded onto its surface; group II was treated with direct application of a nano bone graft covered with pericardium membrane. Clinical and cone beam computed tomography (CBCT) radiographic assessments of the two groups were carried out after a 6-month follow-up period. Results: Clinically, the results showed a significant reduction in furcation involvement (F). The CBCT assessment also revealed reductions in depth (D), height (H), width (W), and 3D radiographic volume of furcation involvement in all study groups at baseline and at 6 months postoperative (p < 0.05) with no significant differences between groups. Conclusions: According to the results of the current study, a two-layer membrane formed by direct loading of bone graft particles onto a pericardium membrane can be used as an effective, reliable, and easy-to-use substitute for direct bone graft application into periodontal defects.
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Affiliation(s)
- Mohamed O. Elboraey
- Oral Medicine, Periodontology, Oral Diagnosis and Radiology Department, Faculty of Dentistry, Tanta University, Tanta 31527, Egypt
- Department of Preventive Dental Sciences and Periodontology, College of Dentistry, Taibah University, Madinah 41411, Saudi Arabia
| | - Eihab A. Mously
- Department of Preventive Dental Sciences and Periodontology, College of Dentistry, Taibah University, Madinah 41411, Saudi Arabia
- Correspondence:
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Jafari N, Habashi MS, Hashemi A, Shirazi R, Tanideh N, Tamadon A. Application of bioactive glasses in various dental fields. Biomater Res 2022; 26:31. [PMID: 35794665 PMCID: PMC9258189 DOI: 10.1186/s40824-022-00274-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 06/09/2022] [Indexed: 12/16/2022] Open
Abstract
AbstractBioactive glasses are a group of bioceramic materials that have extensive clinical applications. Their properties such as high biocompatibility, antimicrobial features, and bioactivity in the internal environment of the body have made them useful biomaterials in various fields of medicine and dentistry. There is a great variation in the main composition of these glasses and some of them whose medical usage has been approved by the US Food and Drug Administration (FDA) are called Bioglass. Bioactive glasses have appropriate biocompatibility with the body and they are similar to bone hydroxyapatite in terms of calcium and phosphate contents. Bioactive glasses are applied in different branches of dentistry like periodontics, orthodontics, endodontics, oral and maxillofacial surgery, esthetic and restorative dentistry. Also, some dental and oral care products have bioactive glasses in their compositions. Bioactive glasses have been used as dental implants in the human body in order to repair and replace damaged bones. Other applications of bioactive glasses in dentistry include their usage in periodontal disease, root canal treatments, maxillofacial surgeries, dental restorations, air abrasions, dental adhesives, enamel remineralization, and dentin hypersensitivity. Since the use of bioactive glasses in dentistry is widespread, there is a need to find methods and extensive resources to supply the required bioactive glasses. Various techniques have been identified for the production of bioactive glasses, and marine sponges have recently been considered as a rich source of it. Marine sponges are widely available and many species have been identified around the world, including the Persian Gulf. Marine sponges, as the simplest group of animals, produce different bioactive compounds that are used in a wide range of medical sciences. Numerous studies have shown the anti-tumor, anti-viral, anti-inflammatory, and antibiotic effects of these compounds. Furthermore, some species of marine sponges due to the mineral contents of their structural skeletons, which are made of biosilica, have been used for extracting bioactive glasses.
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Cannillo V, Salvatori R, Bergamini S, Bellucci D, Bertoldi C. Bioactive Glasses in Periodontal Regeneration: Existing Strategies and Future Prospects-A Literature Review. Materials (Basel) 2022; 15:ma15062194. [PMID: 35329645 PMCID: PMC8954447 DOI: 10.3390/ma15062194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/11/2022] [Accepted: 03/13/2022] [Indexed: 12/22/2022]
Abstract
The present review deals with bioactive glasses (BGs), a class of biomaterials renowned for their osteoinductive and osteoconductive capabilities, and thus widely used in tissue engineering, i.e., for the repair and replacement of damaged or missing bone. In particular, the paper deals with applications in periodontal regeneration, with a special focus on in vitro, in vivo and clinical studies. The study reviewed eligible publications, identified on the basis of inclusion/exclusion criteria, over a ranged time of fifteen years (from 1 January 2006 to 31 March 2021). While there are many papers dealing with in vitro tests, only a few have reported in vivo (in animal) research, or even clinical trials. Regardless, BGs seem to be an adequate choice as grafts in periodontal regeneration.
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Affiliation(s)
- Valeria Cannillo
- Department of Engineering “Enzo Ferrari”, University of Modena and Reggio Emilia, Via P. Vivarelli 10, 41125 Modena, Italy;
- Correspondence:
| | - Roberta Salvatori
- Department of Industrial Engineering and BIOtech Research Center, University of Trento, 38123 Trento, Italy;
| | - Stefania Bergamini
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance (CHIMOMO), University of Modena and Reggio Emilia, 41124 Modena, Italy; (S.B.); (C.B.)
| | - Devis Bellucci
- Department of Engineering “Enzo Ferrari”, University of Modena and Reggio Emilia, Via P. Vivarelli 10, 41125 Modena, Italy;
| | - Carlo Bertoldi
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance (CHIMOMO), University of Modena and Reggio Emilia, 41124 Modena, Italy; (S.B.); (C.B.)
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Assiri H, Dawasaz AA, Alahmari A, Asiri Z. Cone beam computed tomography (CBCT) in periodontal diseases: a Systematic review based on the efficacy model. BMC Oral Health 2020; 20:191. [PMID: 32641102 PMCID: PMC7341656 DOI: 10.1186/s12903-020-01106-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 04/05/2020] [Indexed: 12/13/2022] Open
Abstract
Background Periodontal diseases are prevalent among adult populations. Its diagnosis depends mainly on clinical findings supported by radiographic examinations. In previous decades, cone beam computed tomography has been introduced to the dental field. The aim of this study was to address the diagnostic efficacy of cone-beam computed tomographic (CBCT) imaging in periodontics based on a systematic search and analysis of the literature using the hierarchical efficacy model. Methods A systematic search of electronic databases such as PubMed, Scopus, Web of Science, and Cochrane was conducted in February 2019 to identify studies addressing the efficacy of CBCT imaging in Periodontics. The identified studies were subjected to pre-identified inclusion criteria followed by an analysis using a hierarchical model of efficacy (model) designed for an appraisal of the literature on diagnostic imaging modality. Four examiners performed the eligibility and quality assessment of relevant studies and consensus was reached in cases where disagreement occurred. Results The search resulted in 64 studies. Of these, 34 publications were allocated to the relevant level of efficacy and quality assessments wherever applicable. The overall diagnostic accuracy of the included studies showed a low or moderate risk of bias and applicability concerns in the use of CBCT. In addition, CBCT is accurate in identifying periodontal defects when compared to other modalities. The studies on the level of patient outcomes agreed that CBCT is a reliable tool for the assessment of outcomes after the treatment of periodontal defects. Conclusion CBCT was found to be beneficial and accurate in cases of infra-bony defects and furcation involvements.
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Affiliation(s)
- Hassan Assiri
- Department of Oral Biology and Diagnostic Science, King Khalid University, College of Dentistry, Abha, Saudi Arabia.
| | - Ali Azhar Dawasaz
- Department of Oral Biology and Diagnostic Science, King Khalid University, College of Dentistry, Abha, Saudi Arabia
| | - Ahmad Alahmari
- Department of Periodontology, King Khalid University, College of Dentistry, Abha, Saudi Arabia
| | - Zuhair Asiri
- College of Dentistry, King Khalid University, Abha, Saudi Arabia
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Huang Y, Li L, Shi Z, Cui X, Pan H, Li B. [Application and research status of bioactive glass in bone repair]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2020; 34:660-666. [PMID: 32410437 DOI: 10.7507/1002-1892.201908093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective To summarize the clinical application and research status of bioactive glass (BAG) in bone repair. Methods The recently published literature concerning BAG in bone repair at home and abroad was reviewed and summarized. Results BAG has been widely used in clinical bone repair with a favorable effectiveness. In the experimental aspect, to meet different clinical application needs, BAG has been prepared in different forms, such as particles, prosthetic coating, drug and biological factor delivery system, bone cement, and scaffold. And the significant progress has been made. Conclusion BAG has been well studied in the field of bone repair due to its excellent bone repair performance, and it is expected to become a new generation of bone repair material.
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Affiliation(s)
- Yonghua Huang
- Department of Orthopedics, the Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou Worker's Hospital, Liuzhou Guangxi, 545005, P.R.China
| | - Li Li
- Department of Orthopedics, the Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou Worker's Hospital, Liuzhou Guangxi, 545005, P.R.China
| | - Zhanying Shi
- Department of Orthopedics, the Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou Worker's Hospital, Liuzhou Guangxi, 545005, P.R.China
| | - Xu Cui
- Center for Human Tissues and Organs Degeneration, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen Guangdong, 518055, P.R.China
| | - Haobo Pan
- Center for Human Tissues and Organs Degeneration, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen Guangdong, 518055, P.R.China
| | - Bing Li
- Department of Orthopedics, the Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou Worker's Hospital, Liuzhou Guangxi, 545005, P.R.China
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Siddiqui ZR, Jhingran R, Bains VK, Srivastava R, Madan R, Rizvi I. Comparative evaluation of platelet-rich fibrin versus beta-tri-calcium phosphate in the treatment of Grade II mandibular furcation defects using cone-beam computed tomography. Eur J Dent 2019; 10:496-506. [PMID: 28042265 PMCID: PMC5166306 DOI: 10.4103/1305-7456.195160] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The objective of the study was to evaluate clinically and radiographically the efficacy of platelet-rich fibrin (PRF) versus β-tri-calcium phosphate (β-TCP) in the treatment of Grade II mandibular furcation defects. MATERIALS AND METHODS Forty-five Grade II furcation defect in mandibular molars which were assigned to open flap debridement (OFD) with PRF Group I (n = 15), to OFD with β-TCP Group II (n = 15), and to OFD alone Group III (n = 15) were analyzed for clinical parameters (probing pocket depth [PPD], vertical clinical attachment level [VCAL], horizontal clinical attachment level [HCAL], gingival recession, relative vertical height of furcation [r-VHF], and relative horizontal depth of furcation [r-HDF]) and radiographical parameters (horizontal depth of furcation [H-DOF], vertical height of furcation [V-HOF]) using cone-beam computed tomography (CBCT) at 6 months interval. RESULTS For clinical parameters, reduction in PPD and gain in VCAL and HCAL were higher in Group II as compared to Group I. Change in r-VHF and r-HDF was greater in Group II as compared to Group I. Mean percentage clinical vertical defect fill was higher in Group II as compared to Group I (58.52% ± 11.68% vs. 53.24% ± 13.22%, respectively). On CBCT, mean change at 6 months for all parameters showed nonsignificant difference between the two experimental groups. Mean change in V-HOF was higher in Group I as compared to Group II, but mean change in H-DOF and furcation width was more in Group II as compared to Group I. CONCLUSION For both experimental and control groups, there was statistically significant improvement at 6 months follow-up from baseline values.
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Affiliation(s)
- Zeba Rahman Siddiqui
- Department of Periodontology, Saraswati Dental College and Hospital, Lucknow, Uttar Pradesh, India
| | - Rajesh Jhingran
- Department of Periodontology, Saraswati Dental College and Hospital, Lucknow, Uttar Pradesh, India
| | - Vivek Kumar Bains
- Department of Periodontology, Saraswati Dental College and Hospital, Lucknow, Uttar Pradesh, India
| | - Ruchi Srivastava
- Department of Periodontology, Saraswati Dental College and Hospital, Lucknow, Uttar Pradesh, India
| | - Rohit Madan
- Department of Periodontology, Saraswati Dental College and Hospital, Lucknow, Uttar Pradesh, India
| | - Iram Rizvi
- Department of Periodontology, Saraswati Dental College and Hospital, Lucknow, Uttar Pradesh, India
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Basireddy A, Prathypaty SK, Yendluri DB, Potharaju SP. Demineralized freeze-dried bone allograft with or without platelet-rich fibrin in the treatment of mandibular Degree II furcation defects: A clinical and cone beam computed tomography study. J Indian Soc Periodontol 2019; 23:242-248. [PMID: 31143005 PMCID: PMC6519103 DOI: 10.4103/jisp.jisp_465_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Currently, there is no gold-standard regenerative material for the treatment of furcation defects. The use of bone grafts in combination with guided tissue regeneration membrane is a predictable treatment option but is expensive. Platelet concentrates are increasingly being used owing to their ease of use and cost-effectiveness. Aims The aim of this study is to evaluate the ability of platelet-rich fibrin (PRF) to augment the regenerative effects exerted by demineralized freeze-dried bone allograft (DFDBA) in the treatment of mandibular degree II furcation defects. Materials and Methods Twenty-eight defects in 14 patients with bilateral Degree II mandibular furcation defects were included in the study. The test group was treated with a combination of DFDBA and PRF, while in the control group DFDBA was used alone. Clinical parameters such as probing depth, relative vertical clinical attachment level, relative horizontal clinical attachment level (RHCAL), gingival margin level (GML), plaque index, and sulcus bleeding index were measured at baseline and 6 months. Radiographic parameters, such as vertical defect depth, horizontal defect depth and defect fill, were measured using cone beam computed tomography, taken at baseline and 6 months. Statistical Analysis Used The intragroup and intergroup comparisons were done using the paired t-test. Results The intergroup comparison of mean change in the parameters showed, statistically significant difference in RHCAL (<0.001) and GML (0.014), and no significant difference in other parameters. Conclusions Within the limitations of the present study, PRF seems to favor soft-tissue healing but has no additional benefit in bone regeneration when used in combination with DFDBA.
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Affiliation(s)
- Aravinda Basireddy
- Department of Periodontics, Sri Sai College of Dental Surgery, Hyderabad, Telangana, India
| | | | - Durga Bai Yendluri
- Department of Periodontics, Government Dental College and Hospital, Hyderabad, Telangana, India
| | - Santi Priya Potharaju
- Department of Periodontics, Government Dental College and Hospital, Hyderabad, Telangana, India
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Wanikar I, Rathod S, Kolte AP. Clinico-radiographic evaluation of 1% alendronate gel as an adjunct and smart blood derivative platelet rich fibrin in grade II furcation defects. J Periodontol 2018; 90:52-60. [DOI: 10.1002/jper.18-0146] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 06/02/2018] [Accepted: 06/03/2018] [Indexed: 11/11/2022]
Affiliation(s)
- Ishita Wanikar
- Department of Periodontics & Implantology; VSPM Dental College and Research Centre; Nagpur Maharashtra India
| | - Surekha Rathod
- Department of Periodontics & Implantology; VSPM Dental College and Research Centre; Nagpur Maharashtra India
| | - Abhay P. Kolte
- Department of Periodontics & Implantology; VSPM Dental College and Research Centre; Nagpur Maharashtra India
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Nikolic-Jakoba N, Spin-Neto R, Wenzel A. Cone-Beam Computed Tomography for Detection of Intrabony and Furcation Defects: A Systematic Review Based on a Hierarchical Model for Diagnostic Efficacy. J Periodontol 2016; 87:630-44. [PMID: 26876352 DOI: 10.1902/jop.2016.150636] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The aim of this review is to assess the diagnostic efficacy of cone-beam computed tomography (CBCT) for the diagnosis of and/or treatment planning for intrabony and furcation defects, using a well-known six-tiered hierarchical model for diagnostic efficacy. METHODS The MEDLINE, EMBASE, and Cochrane Library bibliographic databases were searched until August 2015 for studies evaluating CBCT imaging for the diagnosis of and/or treatment planning for intrabony and/or furcation defects. The search strategy was restricted to English language publications using the combination of MeSH terms, free terms, and key words. RESULTS The search strategy yielded 16 publications that qualitatively or quantitatively evaluated the use of CBCT for the detection of intrabony and/or furcation defects and how CBCT influenced the diagnosis and/or treatment plan. According to Quality Assessment of Studies of Diagnostic Accuracy-2, all included studies were medium to low risk of bias. The review identified only one study that investigated the societal efficacy, and none evaluated the patient outcome efficacy or therapeutic efficacy. One study investigated the diagnostic thinking efficacy. All other included studies investigated the diagnostic accuracy of CBCT. CONCLUSIONS From the assessed studies, it can be concluded that there is not sufficient scientific evidence to justify the use of CBCT for the diagnosis of and/or treatment planning for intrabony and furcation defects. Furthermore, the effectiveness of CBCT for such diagnostic tasks has been assessed only at low diagnostic efficacy levels.
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Affiliation(s)
- Natasa Nikolic-Jakoba
- Department of Periodontology, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Rubens Spin-Neto
- Department of Dentistry, Section of Oral Radiology, Aarhus University, Aarhus, Denmark
| | - Ann Wenzel
- Department of Dentistry, Section of Oral Radiology, Aarhus University, Aarhus, Denmark
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