Abstract
Introduction
The aim of the present meta-analysis was to determine the effect of the different incision designs used in apical surgery on periodontal parameters.
Methods
An electronic search in Cochrane Library, Pubmed (MEDLINE), and Scopus was conducted on April 2020. Two independent investigators included clinical trials and prospective cohort studies comparing the influence of different incision designs used in apical surgery on gingival recession, periodontal probing depth, and clinical attachment level. A pairwise and network meta-analysis was performed in order to meta-analyze the direct and the indirect comparisons among the incision designs.
Results
Six articles were included for the qualitative and the quantitative syntheses, involving a total of 401 teeth (372 patients). The pairwise meta-analysis did not reveal statistically significant differences between the incision designs in any of the outcomes evaluated. However, to reduce the amount of buccal gingival recession, the papilla base incision presented the highest probabilities of being ranked the most effective incision (85.7%), followed by submarginal incision (50.0%) and intrasulcular incision (14.3%).
Conclusion
Regardless of the incision design used, the periodontal parameters did not statistically differ after apical surgery.
Clinical relevance
Periodontal parameters did not significantly change despite the incision used in apical surgery. However, based on the results of the present review, the papilla base incision seems to be the best option to reduce the amount of buccal gingival recession.
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Adriana Castro-Calderón declares that she has no conflict of interest. Jorge Toledano-Serrabona declares that he has no conflict of interest. Alba Sánchez-Torres reports grants, personal fees and non-financial support from MozoGrau (Valladolid, Spain) and Mundipharma (Cambridge, UK). Octavi Camps-Font reports grants, personal fees, and non-financial support from Mundipharma (Cambridge, UK) and Menarini Richerche (Florence, Italy). Prof. Dra. Mª Ángeles Sánchez-Garcés declares that she has no conflict of interest. Prof. Dr. Cosme Gay-Escoda reports grants, personal fees, and non-financial support from Mundipharma (Cambridge, UK) and Menarini Richerche (Florence, Italy).
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Supplementary Information
Supplementary Figure 1
Forest plot for buccal gingival recession changes (A), mesial gingival recession changes (B), distal gingival recession changes (C). (JPG 539 kb)
Supplementary Figure 2
Forest plot for buccal periodontal probing depth changes (A), mesial periodontal probing depth changes, distal periodontal probing depth changes (C). (JPG 535 kb)
Supplementary Figure 3
Forest plot for buccal clinical attachment level changes (A), mesial clinical attachment level changes (B), distal clinical attachment level changes (C). (JPG 496 kb)
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Castro-Calderón, A., Toledano-Serrabona, J., Sánchez-Torres, A. et al. Influence of incision on periodontal parameters after apical surgery: a meta-analysis. Clin Oral Invest 25, 4495–4506 (2021). https://doi.org/10.1007/s00784-020-03761-z
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DOI: https://doi.org/10.1007/s00784-020-03761-z