Efficacy of regenerative therapy in aggressive periodontitis: a systematic review and meta-analysis of randomised controlled clinical trials.

OBJECTIVES: To analyse evidence regarding the efficacy of periodontal regenerative procedures in intrabony defects in patients treated for aggressive periodontitis (AgP). MATERIAL AND METHODS: A systematic search of the literature for randomised controlled clinical trials including patients treated for aggressive periodontitis that compared a group treated with regenerative therapy with another group treated with surgical debridement alone was conducted by two independent reviewers. RESULTS: Six studies were included in the meta-analysis of clinical and/or radiographic parameters at 6 and 12 months. Probing pocket depth was smaller at 6 months in patients treated with regenerative therapies compared with those treated with regular debridement (1.00 mm, p < 0.001, 95% CI (0.67, 1.34)). At 12 months this difference was more marked (0.41 mm, p = 0.12, 95% CI (- 0.10, 0.91)). The distance between the cemento-enamel junction and the alveolar crest at both 6 (1.36 mm, p < 0.001, 95% CI (1.03, 1.68)) and 12 months (0.90 mm, p = 0.01, 95% CI (0.24, 1.56)) was smaller in the group treated with regeneration. CONCLUSIONS: The use of biomaterials for regenerative therapy in AgP may be more effective than surgical debridement. Better outcomes were observed in terms of probing pocket depth and distance between the cemento-enamel junction and the alveolar crest at 6 months. Regeneration should be considered as a therapy to prevent tooth loss, although more studies with larger sample size and longer follow-up are needed. CLINICAL RELEVANCE: Periodontal regeneration is effective in the treatment of intrabony defects in patients with AgP, as it leads to better outcomes in clinical and radiographic parameters.