{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T17:46:51Z","timestamp":1779299211299,"version":"3.51.4"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,10,6]],"date-time":"2021-10-06T00:00:00Z","timestamp":1633478400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,10,6]],"date-time":"2021-10-06T00:00:00Z","timestamp":1633478400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The aim of this retrospective study was to assess the outcomes of non-surgical and surgical mechanical root debridement for the treatment of infrabony defects and explore potential prognostic factors. Treated infrabony defects followed for at least 1\u00a0year were selected. All data pertaining to the clinical outcomes were recorded. Multi-level regression analysis and Cox Proportional-Hazards Models were used to assess the immediate (3\u20136\u00a0months) clinical outcomes, survival of the treated teeth, and factors influencing these results. 132 patients were included in the analysis. The analysis showed 1.42\u2009\u00b1\u20091.71 and 2.23\u2009\u00b1\u20091.64\u00a0mm in pocket depth (PD) reduction, 0.13\u2009\u00b1\u20091.83 and 0.08\u2009\u00b1\u20091.76\u00a0mm in clinical attachment level (CAL) gain, and 1.29\u2009\u00b1\u20091.56 and 2.15\u2009\u00b1\u20091.33\u00a0mm increase in gingival recession (REC) for the non-surgical and surgical groups, respectively. The 5-year survival rates were 93% for the non-surgically and 90% for the surgically treated teeth. Several factors affected clinical outcomes and tooth survival. Within its limitations, the treatment of infrabony defects with non-surgical and surgical mechanical root debridement was found to result in moderate but significant PD reduction, nevertheless, this may also be attributable to the resultant REC.<\/jats:p>","DOI":"10.1038\/s41598-021-99205-z","type":"journal-article","created":{"date-parts":[[2021,10,8]],"date-time":"2021-10-08T00:09:47Z","timestamp":1633651787000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The effect of non-surgical and surgical mechanical root debridement on infrabony defects: a retrospective study"],"prefix":"10.1038","volume":"11","author":[{"given":"Jad","family":"Majzoub","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Salami","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shayan","family":"Barootchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenzo","family":"Tavelli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hsun-Liang","family":"Chan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hom-Lay","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,10,6]]},"reference":[{"key":"99205_CR1","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1111\/j.1600-051x.1991.tb00435.x","volume":"18","author":"PN Papapanou","year":"1991","unstructured":"Papapanou, P. N. & Wennstrom, J. L. The angular bony defect as indicator of further alveolar bone loss. J. Clin. Periodontol. 18, 317\u2013322. https:\/\/doi.org\/10.1111\/j.1600-051x.1991.tb00435.x (1991).","journal-title":"J. Clin. Periodontol."},{"key":"99205_CR2","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1002\/JPER.17-0279","volume":"89","author":"TE Rams","year":"2018","unstructured":"Rams, T. E., Listgarten, M. A. & Slots, J. Radiographic alveolar bone morphology and progressive periodontitis. J. Periodontol. 89, 424\u2013430. https:\/\/doi.org\/10.1002\/JPER.17-0279 (2018).","journal-title":"J. Periodontol."},{"issue":"Suppl 1","key":"99205_CR3","doi-asserted-by":"publisher","first-page":"S173","DOI":"10.1002\/JPER.17-0721","volume":"89","author":"PN Papapanou","year":"2018","unstructured":"Papapanou, P. N. et al. Periodontitis: Consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J. Periodontol. 89(Suppl 1), S173\u2013S182. https:\/\/doi.org\/10.1002\/JPER.17-0721 (2018).","journal-title":"J. Periodontol."},{"key":"99205_CR4","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD001724.pub2","author":"IG Needleman","year":"2006","unstructured":"Needleman, I. G., Worthington, H. V., Giedrys-Leeper, E. & Tucker, R. J. Guided tissue regeneration for periodontal infra-bony defects. Cochrane Database Syst. Rev. https:\/\/doi.org\/10.1002\/14651858.CD001724.pub2 (2006).","journal-title":"Cochrane Database Syst. Rev."},{"key":"99205_CR5","doi-asserted-by":"publisher","first-page":"383","DOI":"10.2334\/josnusd.51.383","volume":"51","author":"LC Parrish","year":"2009","unstructured":"Parrish, L. C., Miyamoto, T., Fong, N., Mattson, J. S. & Cerutis, D. R. Non-bioabsorbable vs bioabsorbable membrane: Assessment of their clinical efficacy in guided tissue regeneration technique. A systematic review. J. Oral Sci. 51, 383\u2013400. https:\/\/doi.org\/10.2334\/josnusd.51.383 (2009).","journal-title":"J. Oral Sci."},{"key":"99205_CR6","doi-asserted-by":"publisher","first-page":"773","DOI":"10.1177\/0022034513496428","volume":"92","author":"C Stoecklin-Wasmer","year":"2013","unstructured":"Stoecklin-Wasmer, C. et al. Absorbable collagen membranes for periodontal regeneration: A systematic review. J. Dent. Res. 92, 773\u2013781. https:\/\/doi.org\/10.1177\/0022034513496428 (2013).","journal-title":"J. Dent. Res."},{"key":"99205_CR7","doi-asserted-by":"publisher","first-page":"S77","DOI":"10.1902\/jop.2015.130685","volume":"86","author":"RT Kao","year":"2015","unstructured":"Kao, R. T., Nares, S. & Reynolds, M. A. Periodontal regeneration\u2014intrabony defects: A systematic review from the AAP Regeneration Workshop. J. Periodontol. 86, S77-104. https:\/\/doi.org\/10.1902\/jop.2015.130685 (2015).","journal-title":"J. Periodontol."},{"key":"99205_CR8","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1111\/j.1600-051x.2011.01844.x","volume":"39","author":"YK Tu","year":"2012","unstructured":"Tu, Y. K., Needleman, I., Chambrone, L., Lu, H. K. & Faggion, C. M. Jr. A Bayesian network meta-analysis on comparisons of enamel matrix derivatives, guided tissue regeneration and their combination therapies. J. Clin. Periodontol. 39, 303\u2013314. https:\/\/doi.org\/10.1111\/j.1600-051x.2011.01844.x (2012).","journal-title":"J. Clin. Periodontol."},{"key":"99205_CR9","doi-asserted-by":"publisher","first-page":"746","DOI":"10.1002\/JPER.19-0336","volume":"91","author":"J Majzoub","year":"2020","unstructured":"Majzoub, J. et al. Guided tissue regeneration combined with bone allograft in infrabony defects: Clinical outcomes and assessment of prognostic factors. J. Periodontol. 91, 746\u2013755. https:\/\/doi.org\/10.1002\/JPER.19-0336 (2020).","journal-title":"J. Periodontol."},{"key":"99205_CR10","doi-asserted-by":"publisher","first-page":"863","DOI":"10.1111\/jcpe.13302","volume":"47","author":"F Cieplik","year":"2020","unstructured":"Cieplik, F. et al. Tooth survival and clinical outcomes up to 26 years after guided tissue regeneration therapy in deep intra-bony defects: Follow-up investigation of three randomized clinical trials. J. Clin. Periodontol. 47, 863\u2013874. https:\/\/doi.org\/10.1111\/jcpe.13302 (2020).","journal-title":"J. Clin. Periodontol."},{"key":"99205_CR11","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1111\/jcpe.13110","volume":"46","author":"H Petsos","year":"2019","unstructured":"Petsos, H. et al. Infrabony defects 20 years after open flap debridement and guided tissue regeneration. J. Clin. Periodontol. 46, 552\u2013563. https:\/\/doi.org\/10.1111\/jcpe.13110 (2019).","journal-title":"J. Clin. Periodontol."},{"key":"99205_CR12","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1111\/jcpe.12638","volume":"44","author":"P Cortellini","year":"2017","unstructured":"Cortellini, P., Buti, J., Pini Prato, G. & Tonetti, M. S. Periodontal regeneration compared with access flap surgery in human intra-bony defects 20-year follow-up of a randomized clinical trial: Tooth retention, periodontitis recurrence and costs. J. Clin. Periodontol. 44, 58\u201366. https:\/\/doi.org\/10.1111\/jcpe.12638 (2017).","journal-title":"J. Clin. Periodontol."},{"key":"99205_CR13","doi-asserted-by":"publisher","first-page":"290","DOI":"10.1111\/j.1600-051x.1982.tb02095.x","volume":"9","author":"S Nyman","year":"1982","unstructured":"Nyman, S., Lindhe, J., Karring, T. & Rylander, H. New attachment following surgical treatment of human periodontal disease. J. Clin. Periodontol. 9, 290\u2013296. https:\/\/doi.org\/10.1111\/j.1600-051x.1982.tb02095.x (1982).","journal-title":"J. Clin. Periodontol."},{"key":"99205_CR14","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1902\/jop.1993.64.4.261","volume":"64","author":"P Cortellini","year":"1993","unstructured":"Cortellini, P., Pini Prato, G. & Tonetti, M. S. Periodontal regeneration of human infrabony defects. II. Re-entry procedures and bone measures. J. Periodontol. 64, 261\u2013268. https:\/\/doi.org\/10.1902\/jop.1993.64.4.261 (1993).","journal-title":"J. Periodontol."},{"key":"99205_CR15","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1186\/s13063-019-3544-8","volume":"20","author":"L Nibali","year":"2019","unstructured":"Nibali, L. et al. Minimally invasive non-surgical vs surgical approach for periodontal intrabony defects: A randomised controlled trial. Trials 20, 461. https:\/\/doi.org\/10.1186\/s13063-019-3544-8 (2019).","journal-title":"Trials"},{"key":"99205_CR16","doi-asserted-by":"publisher","first-page":"512","DOI":"10.1902\/jop.2001.72.4.512","volume":"72","author":"EE Machtei","year":"2001","unstructured":"Machtei, E. E. The effect of membrane exposure on the outcome of regenerative procedures in humans: A meta-analysis. J. Periodontol. 72, 512\u2013516. https:\/\/doi.org\/10.1902\/jop.2001.72.4.512 (2001).","journal-title":"J. Periodontol."},{"key":"99205_CR17","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.13381","author":"L Nibali","year":"2020","unstructured":"Nibali, L. et al. Periodontal infrabony defects: Systematic review of healing by defect morphology following regenerative surgery. J. Clin. Periodontol. https:\/\/doi.org\/10.1111\/jcpe.13381 (2020).","journal-title":"J. Clin. Periodontol."},{"issue":"22","key":"99205_CR18","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1034\/j.1600-0757.2000.2220105.x","volume":"2000","author":"NP Lang","year":"2000","unstructured":"Lang, N. P. Focus on intrabony defects\u2013conservative therapy. Periodontol. 2000(22), 51\u201358. https:\/\/doi.org\/10.1034\/j.1600-0757.2000.2220105.x (2000).","journal-title":"Periodontol."},{"key":"99205_CR19","doi-asserted-by":"publisher","first-page":"1256","DOI":"10.1902\/jop.2011.100680","volume":"82","author":"FV Ribeiro","year":"2011","unstructured":"Ribeiro, F. V. et al. Clinical and patient-centered outcomes after minimally invasive non-surgical or surgical approaches for the treatment of intrabony defects: A randomized clinical trial. J. Periodontol. 82, 1256\u20131266. https:\/\/doi.org\/10.1902\/jop.2011.100680 (2011).","journal-title":"J. Periodontol."},{"key":"99205_CR20","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1111\/j.1600-051x.1985.tb00940.x","volume":"12","author":"F Isidor","year":"1985","unstructured":"Isidor, F., Attstrom, R. & Karring, T. Regeneration of alveolar bone following surgical and non-surgical periodontal treatment. J. Clin. Periodontol. 12, 687\u2013696. https:\/\/doi.org\/10.1111\/j.1600-051x.1985.tb00940.x (1985).","journal-title":"J. Clin. Periodontol."},{"key":"99205_CR21","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1111\/j.1600-051x.1985.tb00933.x","volume":"12","author":"S Renvert","year":"1985","unstructured":"Renvert, S., Nilveus, R. & Egelberg, J. Healing after treatment of periodontal intraosseous defects. V. Effect of root planing versus flap surgery. J. Clin. Periodontol. 12, 619\u2013629. https:\/\/doi.org\/10.1111\/j.1600-051x.1985.tb00933.x (1985).","journal-title":"J. Clin. Periodontol."},{"key":"99205_CR22","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1111\/j.1600-051X.2010.01648.x","volume":"38","author":"L Nibali","year":"2011","unstructured":"Nibali, L., Pometti, D., Tu, Y. K. & Donos, N. Clinical and radiographic outcomes following non-surgical therapy of periodontal infrabony defects: A retrospective study. J. Clin. Periodontol. 38, 50\u201357. https:\/\/doi.org\/10.1111\/j.1600-051X.2010.01648.x (2011).","journal-title":"J. Clin. Periodontol."},{"issue":"77","key":"99205_CR23","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1111\/prd.12213","volume":"2000","author":"L Trombelli","year":"2018","unstructured":"Trombelli, L., Simonelli, A., Minenna, L., Vecchiatini, R. & Farina, R. Simplified procedures to treat periodontal intraosseous defects in esthetic areas. Periodontol 2000(77), 93\u2013110. https:\/\/doi.org\/10.1111\/prd.12213 (2018).","journal-title":"Periodontol"},{"issue":"Suppl 22","key":"99205_CR24","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1111\/jcpe.13237","volume":"47","author":"L Nibali","year":"2020","unstructured":"Nibali, L. et al. Regenerative surgery versus access flap for the treatment of intra-bony periodontal defects: A systematic review and meta-analysis. J. Clin. Periodontol. 47(Suppl 22), 320\u2013351. https:\/\/doi.org\/10.1111\/jcpe.13237 (2020).","journal-title":"J. Clin. Periodontol."},{"key":"99205_CR25","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1111\/jcpe.13381","volume":"48","author":"L Nibali","year":"2021","unstructured":"Nibali, L. et al. Periodontal infrabony defects: Systematic review of healing by defect morphology following regenerative surgery. J. Clin. Periodontol. 48, 100\u2013113. https:\/\/doi.org\/10.1111\/jcpe.13381 (2021).","journal-title":"J. Clin. Periodontol."},{"key":"99205_CR26","doi-asserted-by":"publisher","first-page":"1206","DOI":"10.1902\/jop.2012.110550","volume":"83","author":"D Harnacke","year":"2012","unstructured":"Harnacke, D. et al. Oral and written instruction of oral hygiene: A randomized trial. J. Periodontol. 83, 1206\u20131212. https:\/\/doi.org\/10.1902\/jop.2012.110550 (2012).","journal-title":"J. Periodontol."},{"key":"99205_CR27","doi-asserted-by":"publisher","first-page":"1148","DOI":"10.1002\/JPER.19-0529","volume":"91","author":"J Majzoub","year":"2020","unstructured":"Majzoub, J. et al. Treatment effect of guided tissue regeneration on the horizontal and vertical components of furcation defects: A retrospective study. J. Periodontol. 91, 1148\u20131158. https:\/\/doi.org\/10.1002\/JPER.19-0529 (2020).","journal-title":"J. Periodontol."},{"key":"99205_CR28","unstructured":"Kassambara, A., Kosinski, M., Biecek, P. & Fabian, S. Survminer: Drawing survival curves using \u2019ggplot2\u2019. R package version 0.4.8. https:\/\/CRAN.R-project.org\/package=survminer. (2020)."},{"key":"99205_CR29","unstructured":"Therneau, T. A Package for Survival Analysis in R. R package version 3.2-3. https:\/\/CRAN.R-project.org\/package=survival. (2020)."},{"key":"99205_CR30","unstructured":"Wickham, H. ggplot2: Elegant Graphics for Data Analysis. Springer-Verlag New York. ISBN 978-3-319-24277-4. https:\/\/ggplot2.tidyverse.org. (2016)."},{"key":"99205_CR31","doi-asserted-by":"publisher","first-page":"943","DOI":"10.1111\/jcpe.12460","volume":"42","author":"C Graetz","year":"2015","unstructured":"Graetz, C. et al. Prognostic factors for the loss of molars\u2013an 18-years retrospective cohort study. J. Clin. Periodontol. 42, 943\u2013950. https:\/\/doi.org\/10.1111\/jcpe.12460 (2015).","journal-title":"J. Clin. Periodontol."},{"key":"99205_CR32","doi-asserted-by":"publisher","first-page":"612","DOI":"10.1111\/jcpe.12725","volume":"44","author":"C Graetz","year":"2017","unstructured":"Graetz, C. et al. Tooth loss in generalized aggressive periodontitis: Prognostic factors after 17 years of supportive periodontal treatment. J. Clin. Periodontol. 44, 612\u2013619. https:\/\/doi.org\/10.1111\/jcpe.12725 (2017).","journal-title":"J. Clin. Periodontol."},{"key":"99205_CR33","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1111\/j.1600-051X.2011.01815.x","volume":"39","author":"F Graziani","year":"2012","unstructured":"Graziani, F. et al. Clinical performance of access flap surgery in the treatment of the intrabony defect A systematic review and meta-analysis of randomized clinical trials. J. Clin. Periodontol. 39, 145\u2013156. https:\/\/doi.org\/10.1111\/j.1600-051X.2011.01815.x (2012).","journal-title":"J. Clin. Periodontol."},{"key":"99205_CR34","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1111\/j.1600-051x.1980.tb01960.x","volume":"7","author":"MA Listgarten","year":"1980","unstructured":"Listgarten, M. A. Periodontal probing: What does it mean?. J. Clin. Periodontol. 7, 165\u2013176. https:\/\/doi.org\/10.1111\/j.1600-051x.1980.tb01960.x (1980).","journal-title":"J. Clin. Periodontol."},{"key":"99205_CR35","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1002\/JPER.19-0010","volume":"91","author":"P Cortellini","year":"2020","unstructured":"Cortellini, P., Cortellini, S. & Tonetti, M. S. Papilla preservation flaps for periodontal regeneration of molars severely compromised by combined furcation and intrabony defects: Retrospective analysis of a registry-based cohort. J. Periodontol. 91, 165\u2013173. https:\/\/doi.org\/10.1002\/JPER.19-0010 (2020).","journal-title":"J. Periodontol."},{"key":"99205_CR36","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1902\/jop.2004.75.1.16","volume":"75","author":"T Dietrich","year":"2004","unstructured":"Dietrich, T., Bernimoulin, J. P. & Glynn, R. J. The effect of cigarette smoking on gingival bleeding. J. Periodontol. 75, 16\u201322. https:\/\/doi.org\/10.1902\/jop.2004.75.1.16 (2004).","journal-title":"J. Periodontol."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-99205-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-99205-z","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-99205-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,3]],"date-time":"2022-12-03T16:24:14Z","timestamp":1670084654000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-99205-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,6]]},"references-count":36,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["99205"],"URL":"https:\/\/doi.org\/10.1038\/s41598-021-99205-z","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,6]]},"assertion":[{"value":"4 June 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 September 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 October 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"19856"}}