Pocket closure and residual pockets after non-surgical periodontal therapy: A systematic review and meta-analysis

Filippo Citterio, Giacomo Gualini, Moontaek Chang, Gian Marco Piccoli, Marta Giraudi, Valeria Manavella, Giacomo Baima, Giulia Maria Mariani, Federica Romano, Mario Aimetti, Filippo Citterio, Giacomo Gualini, Moontaek Chang, Gian Marco Piccoli, Marta Giraudi, Valeria Manavella, Giacomo Baima, Giulia Maria Mariani, Federica Romano, Mario Aimetti

Abstract

Aim: To analyse the efficacy of non-surgical therapy (NST) in terms of pocket closure (PC) and changes in percentage and number of pockets.

Materials and methods: Three databases (PubMed, EMBASE, and Scopus) were searched up to January 2020. Prospective studies with a minimum follow-up of 12 months and presenting data in terms of PC or number or percentage of pocket depths (PDs) before and after NST on systemically healthy patients were included. Random-effect meta-analyses were performed.

Results: After screening 4610 titles and abstracts, 27 studies were included. Of these, 63.9% of PC was reported by one study. The percentage of PDs ≤3 mm changed from 39.06% to 64.11% with a weighted mean difference (WMD) of 26.14% (p < .001). This accounted for a relative increase of healthy sites of 64.13%. The mean percentage of PD ≥5 mm was 28.23% and 11.71% before and after treatment, respectively, with a WMD of 15.50% (p < .001). The WMD in the number of PDs ≥5 mm before and after treatment was 24.42 (p = .036). The mean number of residual PPD ≥5 after NST was 14.13.

Conclusions: NST is able to eradicate the majority of the pockets. However, residual pockets after NST may remain and should be considered cautiously for further treatment planning.

Keywords: non-surgical periodontal treatment; pocket closure; residual pockets; scaling and root planing.

Conflict of interest statement

The authors declare no conflict of interests.

© 2021 The Authors. Journal of Clinical Periodontology published by John Wiley & Sons Ltd.

Figures

FIGURE 1
FIGURE 1
Flow‐chart of selection and reasons for exclusion
FIGURE 2
FIGURE 2
(a) Risk of bias in randomized controlled clinical trials. (b) Risk of bias in uncontrolled trials. (c) Risk of bias in before and after studies [Colour figure can be viewed at wileyonlinelibrary.com]
FIGURE 3
FIGURE 3
Changes in the percentage of sites with (a) PD ≤3 mm, (b) PD ≥4 mm, and (c) PD ≥5 mm before and after treatment [Colour figure can be viewed at wileyonlinelibrary.com]
FIGURE 4
FIGURE 4
Changes in the percentage of sites with (a) PD 4–6 mm, (b) PD ≥6 mm, and (c) PD ≥7 mm before and after treatment [Colour figure can be viewed at wileyonlinelibrary.com]
FIGURE 5
FIGURE 5
Changes in the number of sites with (a) PD ≥5 mm, (b) PD ≥6 mm, and (c) PD ≥7 mm before and after treatment [Colour figure can be viewed at wileyonlinelibrary.com]

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