{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:25:38Z","timestamp":1789518338770,"version":"build-2803163510"},"reference-count":67,"publisher":"Wiley","issue":"S22","license":[{"start":{"date-parts":[[2020,7,27]],"date-time":"2020-07-27T00:00:00Z","timestamp":1595808000000},"content-version":"vor","delay-in-days":26,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Clinic Periodontology"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>To investigate the clinical performance of regenerative periodontal surgery in the treatment of furcation defects versus open flap debridement (OFD) and to compare different regenerative modalities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>A systematic search was conducted to identify RCTs evaluating regenerative surgical treatment of furcations with a minimum of 12\u2010month follow\u2010up. Three authors independently reviewed, selected and extracted data from the search conducted and assessed risk of bias. Primary outcomes were tooth loss, furcation improvement (closure\/conversion) (FImp), gain of horizontal bone level (HBL) and attachment level (HCAL). Secondary outcomes were gain in vertical attachment level (VCAL), probing pocket depth (PPD) reduction, PROMs and adverse events. Data were summarized into Bayesian standard and network meta\u2010analysis in order to estimate direct and indirect treatment effects and to establish a ranking of treatments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The search identified 19 articles, reporting on 20 RCTs (19 on class II, 1 on class III furcations) with a total of 575 patients\/787 defects. Tooth loss was not reported. Furcation closure ranged between 0% and 60% (10 trials), and class I conversion from 29% to 100% (six trials). Regenerative techniques were superior to OFD for FImp (OR\u00a0=\u00a020.9; 90% CrI\u00a0=\u00a05.81, 69.41), HCAL gain (1.6\u00a0mm), VCAL gain (1.3\u00a0mm) and PPD reduction (1.3\u00a0mm). Bone replacement grafts (BRG) resulted in the highest probability (Pr\u00a0=\u00a061%) of being the best treatment for HBL gain. Non\u2010resorbable membranes\u00a0+\u00a0BRG ranked as the best treatment for VCAL gain (Pr\u00a0=\u00a075%) and PPD reduction (Pr\u00a0=\u00a056%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Regenerative surgery of class II furcations is superior to OFD. FImp (furcation closure or class I conversion) can be expected for the majority of defects. Treatment modalities involving BRG are associated with higher performance.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jcpe.13238","type":"journal-article","created":{"date-parts":[[2019,12,20]],"date-time":"2019-12-20T14:43:46Z","timestamp":1576853026000},"page":"352-374","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":108,"title":["Regenerative surgical treatment of furcation defects: A systematic review and Bayesian network meta\u2010analysis of randomized clinical trials"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4160-5837","authenticated-orcid":false,"given":"S\u00f8ren","family":"Jepsen","sequence":"first","affiliation":[{"name":"Department of Periodontology, Operative and Preventive Dentistry University Hospital Bonn Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1554-9966","authenticated-orcid":false,"given":"Stefano","family":"Gennai","sequence":"additional","affiliation":[{"name":"Sub\u2010Unit of Periodontology, Halitosis and Periodontal Medicine University Hospital of Pisa Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8512-7411","authenticated-orcid":false,"given":"Josefine","family":"Hirschfeld","sequence":"additional","affiliation":[{"name":"Birmingham Dental School &amp; Hospital Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2133-7505","authenticated-orcid":false,"given":"Zamira","family":"Kalemaj","sequence":"additional","affiliation":[{"name":"Private Practice Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9945-0666","authenticated-orcid":false,"given":"Jacopo","family":"Buti","sequence":"additional","affiliation":[{"name":"Unit of Periodontology UCL Eastman Dental Institute London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8780-7306","authenticated-orcid":false,"given":"Filippo","family":"Graziani","sequence":"additional","affiliation":[{"name":"Sub\u2010Unit of Periodontology, Halitosis and Periodontal Medicine University Hospital of Pisa Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,7,27]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-051X.2001.280803.x"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2015.130677"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.2307\/2533446"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.1993.64.10.925"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.1997.tb00220.x"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.1993.64.12.1193"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-148-4-200802190-00008"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12028"},{"key":"e_1_2_8_10_1","first-page":"213","article-title":"Periodontal regeneration in human class II furcations using purified recombinant human platelet\u2010derived growth factor\u2010BB (rhPDGF\u2010BB) with bone allograft","volume":"23","author":"Camelo M.","year":"2003","journal-title":"International Journal of Periodontics and Restorative Dentistry"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-2-1"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0076654"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jds.2013.06.006"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12488"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.1999.70.1.8"},{"key":"e_1_2_8_16_1","first-page":"69","article-title":"The response of human buccal maxillary furcation defects to combined regenerative techniques\u2013two controlled clinical studies","volume":"1","author":"Santana R. B.","year":"1999","journal-title":"Journal of the International Academy of Periodontology"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/31.1.140"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-014-1322-2"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.1991.62.6.361"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.1990.tb01083.x"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.1997.68.7.667"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.1986.tb00854.x"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12460"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12327"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051x.1975.tb01734.x"},{"key":"e_1_2_8_27_1","first-page":"381","article-title":"Treatment of furcation defects with an allograft\u2010alloplast tetracycline composite bone graft combined with GTR: Human histologic evaluation of a case report","volume":"22","author":"Harris R. J.","year":"2002","journal-title":"International Journal of Periodontology and Restorative Dentistry"},{"key":"e_1_2_8_28_1","first-page":"187","volume-title":"Cochrane handbook for systematic review of interventions","author":"Higgins J. P.","year":"2009"},{"key":"e_1_2_8_29_1","unstructured":"Higgins J. P. &Green S.(eds). (2011)Cochrane handbook for systematic reviews of interventions version 5.1.0. The Cochrane Collaboration 2011. Retrieved fromwww.cochrane-handbook.org"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1186"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.1995.66.7.624"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.7326\/M14-2385"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.11607\/prd.1428"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0757.2010.00382.x"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-051X.29.s3.6.x"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2004.75.8.1150"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781119270638.ch7"},{"key":"e_1_2_8_38_1","first-page":"173","article-title":"Treatment of class II furcation defects using resorbable and non\u2010resorbable GTR barriers","volume":"23","author":"Karapataki S.","year":"1999","journal-title":"Swedish Dental Journal"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2010.100306"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-019-02964-3"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1590\/0103-6440201302243"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000100"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.1989.tb02326.x"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1875"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1198\/016214505000001302"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1902\/annals.1997.2.1.229"},{"key":"e_1_2_8_47_1","first-page":"493","article-title":"Comparison of three methods using calcium sulfate as a graft\/barrier material for the treatment of Class II mandibular molar furcation defects","volume":"22","author":"Maragos P.","year":"2002","journal-title":"International Journal of Periodontics & Restorative Dentistry"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.1996.67.7.666"},{"key":"e_1_2_8_49_1","first-page":"6","article-title":"Preferred reporting items for systematic reviews and meta\u2010analyses: The PRISMA statement","volume":"339","author":"Moher D.","year":"2009","journal-title":"PLoS Medicine"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1902\/annals.2003.8.1.266"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2003.74.9.1282"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.13237"},{"key":"e_1_2_8_53_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12756"},{"key":"e_1_2_8_54_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12497"},{"key":"e_1_2_8_55_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.1987.tb00972.x"},{"key":"e_1_2_8_56_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms20061347"},{"key":"e_1_2_8_57_1","first-page":"610","article-title":"Furcation therapy with bioabsorbable collagen membrane: A clinical trial","volume":"68","author":"Pruthi V. K.","year":"2002","journal-title":"Journal of the Canadian Dental Association"},{"key":"e_1_2_8_58_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-015-1642-x"},{"key":"e_1_2_8_59_1","doi-asserted-by":"publisher","DOI":"10.1902\/annals.2003.8.1.227"},{"key":"e_1_2_8_60_1","doi-asserted-by":"publisher","DOI":"10.1177\/0962280207080643"},{"key":"e_1_2_8_61_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12266"},{"key":"e_1_2_8_62_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2009.080605"},{"key":"e_1_2_8_63_1","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12081"},{"key":"e_1_2_8_64_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2001.72.2.238"},{"key":"e_1_2_8_65_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.1988.tb01583.x"},{"key":"e_1_2_8_66_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.2011.01844.x"},{"key":"e_1_2_8_67_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2004.75.11.1493"},{"key":"e_1_2_8_68_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.1994.65.11.1029"}],"container-title":["Journal of Clinical Periodontology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjcpe.13238","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jcpe.13238","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jcpe.13238","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jcpe.13238","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T05:53:47Z","timestamp":1692597227000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jcpe.13238"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7]]},"references-count":67,"journal-issue":{"issue":"S22","published-print":{"date-parts":[[2020,7]]}},"alternative-id":["10.1111\/jcpe.13238"],"URL":"https:\/\/doi.org\/10.1111\/jcpe.13238","archive":["Portico"],"relation":{},"ISSN":["0303-6979","1600-051X"],"issn-type":[{"value":"0303-6979","type":"print"},{"value":"1600-051X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7]]},"assertion":[{"value":"2019-08-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-12-16","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-07-27","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}