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Primary outcomes were tooth survival, clinical attachment (<jats:styled-content style=\"fixed-case\">CAL<\/jats:styled-content>) gain, probing depth (<jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content>) reduction and gingival recession increase (<jats:styled-content style=\"fixed-case\">REC<\/jats:styled-content>). Weighted means and forest plots were calculated for each outcome variable 12\u00a0months after surgery. Long\u2010term stability was explored with <jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s of at least 24\u00a0months of follow\u2010up. Subgroup analysis was performed according to the type of flap.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010seven trials reporting 647 subjects and 734 defects were identified. Twelve months after <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content>, tooth survival was 98% (<jats:styled-content style=\"fixed-case\">IQ<\/jats:styled-content>: 96.77\u2013100), <jats:styled-content style=\"fixed-case\">CAL<\/jats:styled-content> gain 1.65\u00a0mm (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 1.37\u20131.94; <jats:italic>p\u00a0<\/jats:italic>&lt;\u00a00.0001), <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content> reduction 2.80\u00a0mm (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 2.43\u20133.18; <jats:italic>p\u00a0<\/jats:italic>&lt;\u00a00.0001) and <jats:styled-content style=\"fixed-case\">REC<\/jats:styled-content> increase 1.26\u00a0mm (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0.94\u20131.49; <jats:italic>p\u00a0<\/jats:italic>&lt;\u00a00.0001). Longer follow\u2010up showed similar findings. <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> of <jats:styled-content style=\"fixed-case\">CAL<\/jats:styled-content> gain were 1.44\u20133.52 for recently introduced papilla preservation flaps and 1.25\u20131.89\u00a0mm for access flaps.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The treatment of intrabony defect with <jats:styled-content style=\"fixed-case\">CS<\/jats:styled-content> is associated with high tooth retention and improvement of periodontal clinical parameters. Clinical performance may vary according to the type of surgical flap used.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1600-051x.2011.01815.x","type":"journal-article","created":{"date-parts":[[2011,11,28]],"date-time":"2011-11-28T05:28:55Z","timestamp":1322458135000},"page":"145-156","source":"Crossref","is-referenced-by-count":106,"title":["Clinical performance of access flap surgery in the treatment of the intrabony defect. A systematic review and meta\u2010analysis of randomized clinical trials"],"prefix":"10.1111","volume":"39","author":[{"given":"Filippo","family":"Graziani","sequence":"first","affiliation":[{"name":"Department of Surgery, Unit of Dentistry and Oral Surgery University of Pisa Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Gennai","sequence":"additional","affiliation":[{"name":"Department of Surgery, Unit of Dentistry and Oral Surgery University of Pisa Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Cei","sequence":"additional","affiliation":[{"name":"Department of Surgery, Unit of Dentistry and Oral Surgery University of Pisa Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Cairo","sequence":"additional","affiliation":[{"name":"Department of Periodontology University of Florence Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Baggiani","sequence":"additional","affiliation":[{"name":"Department of Experimental Pathology, Medical Biotechnologies, Infectious Diseases and Epidemiology University of Pisa Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Miccoli","sequence":"additional","affiliation":[{"name":"Department of Experimental Pathology, Medical Biotechnologies, Infectious Diseases and Epidemiology University of Pisa Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Gabriele","sequence":"additional","affiliation":[{"name":"Department of Surgery, Unit of Dentistry and Oral Surgery University of Pisa Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Tonetti","sequence":"additional","affiliation":[{"name":"European Research Group on Periodontology Genova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2011,11,27]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2005.76.8.1354"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.1998.tb02402.x"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.1995.66.9.797"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.1996.67.3.217"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.1995.66.4.261"},{"key":"e_1_2_5_7_1","first-page":"589","article-title":"The simplified papilla preservation flap. 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