Fiber Retention Osseous Resective Surgery for Shallow Intrabony Defects: A Comparative Systematic Review and Meta-analysis.

Abstract

This is the first systematic review and meta-analysis to evaluate fiber retention osseous resective surgery (FibReORS) versus conventional osseous resective surgery (ORS) for shallow intrabony defects, and to summarize the treatment effects of FibReORS via single-arm analyses. PubMed/MEDLINE, Embase, Scopus, Web of Science, and Cochrane CENTRAL were searched on July 1st, 2026, to identify randomized controlled trials (RCTs) assessing defects < 3 mm with ≥ 6 months follow-up. Periodontal probing depth (PPD) was the primary outcome, while gingival recession (REC), pain, edema, and fibrin deposits were secondary outcomes. Five publications reporting three RCTs met the inclusion criteria. Meta-analysis (41 patients, 54 sites) showed less REC with FibReORS at 12 months (MD = -1.35 mm; p < 0.0001), with no significant PPD difference (MD = -0.12 mm; p = 0.3327). At 1 week (43 patients, 56 sites), FibReORS was associated with lower pain (p < 0.0001), edema (p = 0.0249) and fibrin deposition (p = 0.0016). For shallow intrabony defects, FibReORS may provide PPD outcomes comparable to ORS while limiting REC and reducing short-term postoperative morbidity; however, these findings derive from only three small, short term RCTs graded as low to very low certainty, warranting cautious interpretation and further high-quality studies.