{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:11:49Z","timestamp":1791389509354,"version":"4.3.3"},"reference-count":54,"publisher":"Wiley","license":[{"start":{"date-parts":[[2025,9,28]],"date-time":"2025-09-28T00:00:00Z","timestamp":1759017600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Periodontology 2000"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>This systematic review investigated the efficacy of biologic factors in the surgical treatment of periodontal suprabony defects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>Three databases were searched to identify RCTs comparing open\u2010flap debridement (OFD) combined with biologic factors only, or combined with bone substitute, and\/or barriers to the same intervention without biologics or OFD in terms of probing pocket depth (PPD) reduction, clinical attachment level (CAL) gain, and number of pockets closed. Risk of bias was performed according to RoB 2. Pairwise meta\u2010analyses and frequentist network meta\u2010analyses by using random\u2010effects models were performed. GRADE was employed to assess the certainty of evidence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ten studies reporting on 253 subjects were included. Overall, adding biologics to OFD leads to a significant improvement in post\u2010treatment PPD and CAL at 9\u201312\u2009months, with enamel matrix derivative (EMD) having the highest probability of being the best biologic for changes in PPD (\u22121.91\u2009mm, 95% CI: \u22123.02, \u22120.81) and CAL (\u22122.24\u2009mm, 95% CI: \u22122.68, \u22121.79) at a low level of evidence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The addition of biologics provides an adjunctive benefit in post\u2010treatment PPD and CAL. However, data should be interpreted with caution due to the heterogeneity of studies, limited data available, risk of bias, and low\/moderate evidence.<\/jats:p><\/jats:sec>","DOI":"10.1111\/prd.70013","type":"journal-article","created":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T05:05:06Z","timestamp":1759122306000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The efficacy of biologic factors on the surgical therapy of periodontal suprabony defects: A systematic review and network meta\u2010analysis of randomized clinical trials"],"prefix":"10.1111","author":[{"given":"Carrie","family":"Chew","sequence":"first","affiliation":[{"name":"Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry Queen Mary University London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4117-9073","authenticated-orcid":false,"given":"Nikolaos","family":"Donos","sequence":"additional","affiliation":[{"name":"Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry Queen Mary University London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8428-8811","authenticated-orcid":false,"given":"Stefano","family":"Corbella","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Surgical and Dental Sciences Universit\u00e0 Degli Studi di Milano  Milan Italy"},{"name":"IRCCS Ospedale Galeazzi Sant'ambrogio  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Manso","sequence":"additional","affiliation":[{"name":"Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry Queen Mary University London  London UK"},{"name":"Federal University of Santa Catarina  Florianopolis Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greta","family":"Castellini","sequence":"additional","affiliation":[{"name":"Unit of Clinical Epidemiology IRCCS Istituto Ortopedico Galeazzi  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8781-1997","authenticated-orcid":false,"given":"Elena","family":"Calciolari","sequence":"additional","affiliation":[{"name":"Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry Queen Mary University London  London UK"},{"name":"Centro di Odontoiatria, Dipartimento di Medicina e Chirurgia Universit\u00e0 di Parma  Parma Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,28]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.13290"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.13245"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.2007.01111.x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.23-0285"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0757.2000.2220102.x"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.4103\/0972-124X.75914"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0757.1999.tb00145.x"},{"key":"e_1_2_8_9_1","first-page":"425","article-title":"Reconstruction of supracrestal alveolar bone lost as a result of severe chronic periodontitis. 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