Understanding patient responses to periodontal regeneration is crucial. This systematic review and meta‐analysis addressed two key questions: (a) the impact of periodontal regeneration on patient‐reported outcome measures (PROMs) for intrabony and furcation involvement and (b) the cost‐effectiveness of periodontal regeneration for treating periodontal defects. Twenty‐four studies were included, with 20 randomized clinical trials (RCTs) reporting patient‐reported outcomes and five (three RCTs and two economic model‐based studies) reporting cost‐effectiveness outcomes. Results favored regeneration therapy over conventional flap surgery for intrabony defects, showing improvements in qualitative (i.e., amount of regenerated attachment apparatus) and quantitative parameters (i.e., probing and radiographic parameters). In terms of PROMs, regenerative treatments involving barrier membranes resulted in longer chair times and higher rates of complications (such as membrane exposure or edema) compared to flap with biologic agents or access flap alone. Despite this, oral health‐related quality of life improved after both regenerative and extraction procedures. Economically, regeneration remained favorable compared to extraction and replacement or open flap debridement alone for periodontal defects. Single‐flap variants in open flap debridement yielded similar outcomes to regenerative treatment, offering a potentially cost‐effective option. Nevertheless, further discussion on the benefits of less‐invasive flap designs is needed due to the lack of histological evaluation.

中文翻译：

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再生牙周治疗中患者报告的结果测量和健康经济学：系统评价和荟萃分析


了解患者对牙周再生的反应至关重要。这项系统回顾和荟萃分析解决了两个关键问题：（a）牙周再生对骨内和分叉受累的患者报告结果测量（PROM）的影响；（b）牙周再生治疗牙周缺损的成本效益。纳入了 24 项研究，其中 20 项随机临床试验 (RCT) 报告患者报告的结果，5 项（三项随机临床试验和两项基于经济模型的研究）报告成本效益结果。结果显示，对于骨内缺陷，再生疗法优于传统皮瓣手术，显示出定性（即再生附着装置的数量）和定量参数（即探测和放射学参数）的改善。就 PROM 而言，与使用生物制剂的皮瓣或单独使用皮瓣相比，涉及屏障膜的再生治疗会导致更长的治疗时间和更高的并发症发生率（例如膜暴露或水肿）。尽管如此，在再生和拔牙手术后，口腔健康相关的生活质量得到了改善。从经济角度来看，与单独拔牙置换或开放瓣清创术治疗牙周缺损相比，再生仍然有利。开放皮瓣清创术中的单皮瓣变体产生了与再生治疗相似的结果，提供了一种潜在的具有成本效益的选择。然而，由于缺乏组织学评估，需要进一步讨论微创皮瓣设计的好处。