Use Of Growth Factors In The Treatment Of Furcation Defects:a Meta-analysis

Objective:Using the method of meta-analysis,we collected the randomized controlled trials of growth factor in the treatment of furcation defects,and made a systematic review to evaluate the role of growth factor in improving the tissue defect of root furcation area,so as to provide a more reasonable method for the clinical treatment of root furcation lesions.Methods:From January 1990 to January 2021,they were retrieved from Pub Med,EMBASE,Cochrane Library and web of The key words are "root furcation disease,root furcation disease,growth factor,platelet derivative,platelet rich fibrin,concentrated growth factor,enamel protein,dental plaque" Two independent researchers used endnote to manually search the literatures retrieved by computer.According to the established criteria,the included literatures were screened,and then the literatures were screened again.Revman 5.4.1 software was used for meta analysis,and the test level of meta analysis was p = 0.05.Results:After the final screening,19 articles were included in this study.One of them was unable to carry out quantitative analysis due to incomplete measurement data.From the qualitative analysis,compared with simple flap turnover,EMD combined with growth factor enamel matrix derivative has significantly improved the bone defect of horizontal attachment and bifurcation area,and has statistical significance.In the 18 quantitative analysis,the outcome indicators involved in this study were all continuous variables.In the first study,both of them were control trials(OFD + GF and OFD)of flap surgery combined with growth factor and simple flap surgery.The PD reduction of probing depth was statistically significant [MD=1.36,95%CI(0.95,1.99),P<0.00001],and the gain of vertical attachment loss was statistically significant [MD=1.32,95%CI(0.99,1.65),P<0.00001],The gain of horizontal attachment loss was statistically significant[MD=1.07,95%CI(0.75,1.38),P<0.00001],the gingival recession was not statistically significant [MD=-0.00,95%CI(-0.32,0.31),P=0.98],and the reduction of bone defect in bifurcation area was also statistically significant.In the second study,both of them were control trials(OFD + BG + GF and OFD+ BG)of flap bone grafting combined with growth factor and flap bone grafting alone.The PD reduction of probing depth was statistically significant [MD=0.45,95%CI(0.03,0.87),P=0.04],and the gain of vertical attachment loss was statistically significant [MD=0.57,95% CI(0.17,0.97)P=0.005],The gain of horizontal attachment loss was statistically significant[MD=0.97,95%CI(0.57,1.37),P<0.00001],but the gingival recession was not statistically significant[MD=-0.16,95%CI(-0.36,0.05),P=0.13].Conclusion:(1)Compared with flap surgery alone,flap surgery combined with growth factor can effectively improve the periodontal probing depth,attachment level and regeneration of bone defect of root bifurcation;(2)Compared with the simple flap grafting,flap grafting combined with growth factor can improve the periodontal probing depth,attachment level and regeneration of bone defect;(3)The application of growth factor did not significantly improve gingival recession;...