title: An evaluation of bioactive glass in the treatment of periodontal defects: a meta-analysis of randomized controlled clinical trials.
abstract: BACKGROUND
  The regenerative surgical treatment of intrabony defects caused by periodontal disease has been examined in several systematic reviews and meta-analyses. The use of bioactive glass (BG) as a graft material to treat intrabony defects has been reported, but all data have not been synthesized and compiled. Our objective was to systematically review the literature on the use of BG for the treatment of intrabony defects and to perform a meta-analysis of its efficacy.
  
  
  METHODS
  A search of PubMed, EMBASE, and Cochrane Database of Systematic Reviews, as well as a manual search of recently published periodontology journals, were conducted to identify randomized controlled trials of the use of BG in the treatment of intrabony and furcation defects. Criteria included publication in English, follow-up duration of ≥6 months, baseline and follow-up measures of probing depth (PD) and clinical attachment levels (CAL) with 95% confidence intervals (CIs), and an appropriate control arm. Twenty-five citations were identified, 15 of which were included in the final analysis. Data, including study methods and results, as well as CONSORT (Consolidated Standards of Reporting Trials) criteria, were extracted from eligible studies and cross-checked by at least two reviewers.
  
  
  RESULTS
  Meta-analyses of eligible studies were performed to ascertain summary effects for changes in PD and CAL among experimental and control groups, using the mean change plus standard deviation for each study. Pooled analyses showed that BG was superior to control for both measures: the mean (95% CIs) difference from baseline to follow-up between BG and controls was 0.52 mm (0.27, 0.78, P <0.0001) in reduction for PD and 0.60 mm (0.18, 1.01, P = 0.005) in gain for CAL. Analyses of CAL revealed heterogeneity across studies (I(2) = 60.5%), although studies reporting PD measures were homogeneous (I(2) = 0.00%). CAL heterogeneity appeared secondary to active controls versus open flap debridement (OFD) alone and to defect-type modifying BG treatment success. Per subgroup analyses, the benefit of BG over control treatment was highly significant only in studies comparing BG to OFD (P <0.0001), with mean difference change in CAL being 1.18 mm (95% CI = 0.74, 1.62 mm) between the BG and OFD group.
  
  
  CONCLUSIONS
  Treatment of intrabony defects with BG imparts a significant improvement in both PD and CAL compared to both active controls and OFD.
authors.affiliation: Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA 02115, USA.
authors.forename: Keyvan
authors.initials: K
authors.lastname: Sohrabi
authors.forename: Veeral
authors.initials: V
authors.lastname: Saraiya
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Laage
authors.forename: Maureen
authors.initials: M
authors.lastname: Harris
authors.forename: Marissa
authors.initials: M
authors.lastname: Blieden
authors.forename: Nadeem
authors.initials: N
authors.lastname: Karimbux
mesh_terms: D016301:Alveolar Bone Loss / Q000601:surgery*; D015982:Bias; D001672:Biocompatible Materials / Q000737:chemistry; D018786:Bone Substitutes / Q000627:therapeutic use*; D005500:Follow-Up Studies; D017823:Furcation Defects / Q000601:surgery; D005898:Glass / Q000737:chemistry; D006801:Humans; D017622:Periodontal Attachment Loss / Q000601:surgery; D010514:Periodontal Pocket / Q000601:surgery; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D012680:Sensitivity and Specificity
chemical_list: D001672:Biocompatible Materials; D018786:Bone Substitutes