title: Minimally Invasive Surgery Combined with Regenerative Biomaterials in Treating Intra-Bony Defects: A Meta-Analysis.
abstract: BACKGROUND
  With the popularity of minimally invasive surgery (MIS) in periodontics, numerous publications have evaluated the benefits of MIS with or without various regenerative biomaterials in the treatment of periodontal intra-bony defects. However, it is unclear if it is necessary to use biomaterials in MIS. Thus, we conducted a meta-analysis of randomized clinical trials in patients with intra-bony defects to compare the clinical outcomes of MIS with regenerative biomaterials for MIS alone.
  
  
  METHODS
  The authors retrieved English publications on relevant studies from Cochrane CENTRAL, PubMed, Medline, Embase, Clinical Evidence, and ClinicalTrials.gov (up to June 30, 2015). The main clinical outcomes were the reduction of probing pocket depths (PPDs), gain of clinical attachment level (CAL), recession of gingival margin (REC) and radiographic bone fill. Review Manager 5.2 (Cochrane Collaboration, Oxford, England) was used to calculate the heterogeneity and mean differences of the main clinical outcomes.
  
  
  RESULTS
  In total, 464 studies in the literature were identified but only four were ultimately feasible. The results showed no significant difference regarding CAL gain (P = 0.32) and PPD reduction (P = 0.40) as well as REC increase (P = 0.81) and radiographic bone fill (P = 0.64) between the MIS plus biomaterials group and the MIS alone group.
  
  
  CONCLUSIONS
  The meta-analysis suggested no significant difference in treatment of intra-bony defects between the MIS plus biomaterials group and the MIS alone group, indicating that it is important to take costs and benefits into consideration when a decision is made about a therapeutic approach. There needs to be an in-depth exploration of the induction of intrinsic tissue healing of MIS without biomaterials to achieve optimal outcomes.
authors.affiliation: College of Stomatology, Chongqing Medical University, Chongqing, China.|Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China.|Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.
authors.forename: Shan
authors.initials: S
authors.lastname: Liu
authors.affiliation: College of Stomatology, Chongqing Medical University, Chongqing, China.|Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China.|Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Hu
authors.affiliation: Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, NC, 27157, United States of America.
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: College of Stomatology, Chongqing Medical University, Chongqing, China.|Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China.|Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.
authors.forename: Wenyang
authors.initials: W
authors.lastname: Li
authors.affiliation: College of Stomatology, Chongqing Medical University, Chongqing, China.|Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China.|Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.
authors.forename: Jinlin
authors.initials: J
authors.lastname: Song
mesh_terms: D001861:Bone Regeneration; D018786:Bone Substitutes / Q000627:therapeutic use*; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*
chemical_list: D018786:Bone Substitutes