The Efficacy of Pocket Elimination/Reduction Compared to Access Flap Surgery: A SystematicReview and Meta-analysis To assess the efficacy and adverse effects of resective surgery compared to access flap in patients with periodontitis.

2. The Efficacy of Pocket Elimination/Reduction
Compared to Access Flap Surgery: A Systematic
Review and Meta-analysis
Polak David, Wilensky, Antonoglou, Shapira, Goldstein, Martin Conchita

3. AIM
To assess the efficacy and adverse effects of resective
surgery compared to access flap in patients with
periodontitis.

4. PICOS question was proposed: “In adult patients with
periodontitis after an initial step of supra/subgingival
biofilm control and residual PPD of 5 mm or more, what is
the efficacy of pocket elimination/reduction surgery in
comparison with access flap surgery in terms of PPD
reduction?”

5. Inclusion Criteria:
• Prospective controlled clinical trials with more than 10
human subjects per group
• Patients >18 years old with periodontitis, all patients
received full-mouth clinical examination
• Treated teeth had PPD of ≥5 mm
• Control groups underwent subgingival debridement with
access flap or sister technique
• Reports included PPD and CAL, 6 months or more
follow-up.

6. Exclusion Criteria:
• Use of biomaterials / additional procedures for the same
surgery including regenerative procedures
• Endodontic-periodontal lesions
• Periodontal treatment aiming to treat specifically furcation
involvements
• Studies published as editorials, letters, comments, case
series and case report.