title: Which biomaterials may promote periodontal regeneration in intrabony periodontal defects? A systematic review of preclinical studies.
abstract: OBJECTIVE
  To systematically analyze the regenerative effect of the available biomaterials either alone or in various combinations for the treatment of periodontal intrabony defects as evaluated in preclinical histologic studies.
  
  
  METHODS
  A protocol covered all aspects of the systematic review methodology. A literature search was performed in Medline, including hand searching. Combinations of searching terms and several criteria were applied for study identification, selection, and inclusion. The preliminary outcome variable was periodontal regeneration after reconstructive surgery obtained with the various regenerative materials, as demonstrated through histologic/ histomorphometric analysis. New periodontal ligament, new cementum, and new bone formation as a linear measurement in mm or as a percentage of the instrumented root length were recorded. Data were extracted based on the general characteristics, study characteristics, methodologic characteristics, and conclusions. Study selection was limited to preclinical studies involving histologic analysis, evaluating the use of potential regenerative materials (ie, barrier membranes, grafting materials, or growth factors/proteins) for the treatment of periodontal intrabony defects. Any type of biomaterial alone or in various combinations was considered. All studies reporting histologic outcome measures with a healing period of at least 6 weeks were included. A meta-analysis was not possible due to the heterogeneity of the data.
  
  
  CONCLUSIONS
  Flap surgery in conjunction with most of the evaluated biomaterials used either alone or in various combinations has been shown to promote periodontal regeneration to a greater extent than control therapy (flap surgery without biomaterials). Among the used biomaterials, autografts revealed the most favorable outcomes, whereas the use of most biologic factors showed inferior results compared to flap surgery.
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Ivanovic
authors.forename: George
authors.initials: G
authors.lastname: Nikou
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Miron
authors.forename: Dimitris
authors.initials: D
authors.lastname: Nikolidakis
authors.forename: Anton
authors.initials: A
authors.lastname: Sculean
mesh_terms: D016301:Alveolar Bone Loss / Q000601:surgery*; D000818:Animals; D001672:Biocompatible Materials / Q000494:pharmacology*; D001861:Bone Regeneration; D018786:Bone Substitutes / Q000494:pharmacology; D016025:Bone Transplantation; D017823:Furcation Defects / Q000601:surgery*; D006133:Growth Substances / Q000494:pharmacology; D016557:Guided Tissue Regeneration, Periodontal / Q000295:instrumentation*; D008567:Membranes, Artificial; D013524:Surgical Flaps
chemical_list: D001672:Biocompatible Materials; D018786:Bone Substitutes; D006133:Growth Substances; D008567:Membranes, Artificial