Effect and timing of non-surgical treatment prior to periodontal regeneration: a systematic review

Abstract

The aim of this systematic review was to assess the study design and reporting of studies on periodontal regeneration, with respect to the effect of the provision of non-surgical periodontal therapy (NSPT) before surgery. A systematic search of the literature was conducted for studies on periodontal regeneration on Medline and EMBASE, complemented by a manual search. Initially, 3310 potentially eligible articles were identified. A total of 293 studies were included in the review. Nearly 10% of studies did not include NSPT in the study protocol before regenerative surgery, while 14% of papers did not report this aspect. Seventy-six percent of studies reported that non-surgical subgingival debridement was performed before periodontal surgery (2 weeks to 6 months before surgery according to the different studies). However, no papers reported clinical and radiographic data before and after NSPT prior to periodontal surgery. Only 45% of papers reported timing of reassessment following NSPT, prior to proceeding with regenerative surgery. This review highlights the lack of reporting information on non-surgical periodontal therapy prior to periodontal regenerative surgery, calling for a revision of the current clinical protocols and of the study designs of periodontal regenerative surgery studies. Periodontal regenerative surgery protocols should take into account the possible effects of non-surgical periodontal therapy in the clinical and radiographic healing of intrabony defects.