Effectiveness of Endoscope-Assisted Subgingival Debridement Versus Repeated Root Surface Debridement or Access Flap Periodontal Surgery in Step 3 Periodontal Therapy: A Systematic Review and Meta-Analysis

IF 2.2 Q3 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical and Experimental Dental Research Pub Date : 2025-07-31 DOI:10.1002/cre2.70196

King-Lun Dominic Ho, Melissa Rachel Fok, Kar Yan Li, Georgios Pelekos, Wai Keung Leung

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Abstract

Objectives

Periodontitis is a multifactorial inflammatory disease leading to the progressive destruction of the tooth-supporting apparatus. The management of residual periodontal pockets remains a challenge for Step 3 periodontal therapy. This systematic review aims to evaluate the potential and efficacy of the periodontal endoscope in managing residual periodontal pockets during Step 3 periodontal therapy.

Material and Methods

A comprehensive search was conducted in Medline, PubMed, Cochrane Library, Embase, Scopus, and Web of Science databases up to December 2024. Studies included were randomized controlled trials (RCTs) comparing periodontal endoscope-assisted subgingival debridement (EASD) with repeated root surface debridement (RSD) and access flap periodontal surgery (AFPS). Data extraction and risk of bias assessment were performed independently by two reviewers.

Results

Five RCTs were included, involving 155 subjects and 4072 sites. EASD showed a significantly higher periodontal probing depth (PPD) reduction compared to repeated RSD, with a weighted mean difference (WMD) of 0.5 mm (95% CI: 0.19–0.81) at 3-month postoperation. At 6-month postoperation, the WMD of PPD and clinical attachment level (CAL) changes were 0.84 mm (95% CI: 0.60–1.09) and 0.89 mm (95% CI: 0.45–1.34), respectively, in favor of EASD. EASD showed a significantly higher prevalence ratio (20%) of pocket resolution (PPD ≤ 4 mm) compared to repeated RSD at 6-month postoperation. No significant differences were observed between EASD and AFPS in the changes of CAL, PPD and prevalence of pocket resolution (PPD ≤ 4 mm). The overall certainty of the evidence was deemed to be “low” for EASD versus repeated RSD comparisons and “moderate” for EASD versus AFPS comparisons.

Conclusions

EASD demonstrated superior clinical outcomes compared to repeated RSD in managing residual periodontal pockets. Further high-quality research is necessary to validate these findings and explore the long-term benefits of EASD.

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查看原文本刊更多论文

内窥镜辅助龈下清创与重复根面清创或通道瓣牙周手术在牙周治疗第3步中的有效性：系统回顾和meta分析

目的牙周炎是一种多因素的炎症性疾病，可导致牙齿支撑器的进行性破坏。残余牙周袋的管理仍然是第三步牙周治疗的挑战。本系统综述旨在评估牙周内窥镜在牙周治疗步骤3中处理残留牙周袋的潜力和疗效。材料与方法综合检索Medline、PubMed、Cochrane Library、Embase、Scopus和Web of Science数据库，检索截止到2024年12月。纳入的研究是随机对照试验（RCTs），比较牙周内窥镜辅助龈下清创（EASD）与重复根面清创（RSD）和通道瓣牙周手术（AFPS）。数据提取和偏倚风险评估由两名审稿人独立完成。结果共纳入5项随机对照试验，共155名受试者，4072个站点。与重复RSD相比，EASD术后3个月的牙周探诊深度（PPD）降低明显更高，加权平均差（WMD）为0.5 mm （95% CI: 0.19-0.81）。术后6个月，PPD WMD和临床附着水平（CAL）变化分别为0.84 mm （95% CI: 0.60-1.09）和0.89 mm (95% CI: 0.45-1.34)，有利于EASD。术后6个月，与重复RSD相比，EASD的口袋分辨率（PPD≤4 mm）的患病率（20%）明显更高。EASD与AFPS在CAL、PPD变化及口袋分辨率（PPD≤4 mm）患病率方面无显著差异。与重复RSD比较，EASD证据的总体确定性被认为是“低”的，与AFPS比较，EASD证据的总体确定性被认为是“中等”的。结论与重复RSD相比，EASD在治疗残留牙周袋方面表现出更好的临床效果。需要进一步的高质量研究来验证这些发现并探索EASD的长期益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Experimental Dental Research DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

3.30

自引率

5.60%

发文量

165

审稿时长

26 weeks

期刊介绍： Clinical and Experimental Dental Research aims to provide open access peer-reviewed publications of high scientific quality representing original clinical, diagnostic or experimental work within all disciplines and fields of oral medicine and dentistry. The scope of Clinical and Experimental Dental Research comprises original research material on the anatomy, physiology and pathology of oro-facial, oro-pharyngeal and maxillofacial tissues, and functions and dysfunctions within the stomatognathic system, and the epidemiology, aetiology, prevention, diagnosis, prognosis and therapy of diseases and conditions that have an effect on the homeostasis of the mouth, jaws, and closely associated structures, as well as the healing and regeneration and the clinical aspects of replacement of hard and soft tissues with biomaterials, and the rehabilitation of stomatognathic functions. Studies that bring new knowledge on how to advance health on the individual or public health levels, including interactions between oral and general health and ill-health are welcome.