Evidence map›Paper›PMID 39419270›Full record

ArticleJournal of clinical periodontology2025

Endoscopic Re-Instrumentation of Intrabony Defect-Associated Deep Residual Periodontal Pockets Is Non-Inferior to Papilla Preservation Flap Surgery: A Randomized Trial.

King-Lun Dominic Ho, Ka-Leong Ryan Ho, George Pelekos, Wai-Keung Leung, Maurizio S Tonetti

Abstract readEquivalence Trial
In one paragraph

Article in Journal of clinical periodontology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Review
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

King-Lun Dominic HoDivision of Periodontology and Implant Dentistry, Faculty of Dentistry, Prince Philip Dental Hospital, The University of Hong Kong, Hong Kong SAR, China.
Ka-Leong Ryan HoDivision of Periodontology and Implant Dentistry, Faculty of Dentistry, Prince Philip Dental Hospital, The University of Hong Kong, Hong Kong SAR, China.
George PelekosDivision of Periodontology and Implant Dentistry, Faculty of Dentistry, Prince Philip Dental Hospital, The University of Hong Kong, Hong Kong SAR, China.ORCID 0000-0003-1917-1988
Wai-Keung LeungDivision of Periodontology and Implant Dentistry, Faculty of Dentistry, Prince Philip Dental Hospital, The University of Hong Kong, Hong Kong SAR, China.ORCID 0000-0003-1979-910X
Maurizio S TonettiDivision of Periodontology and Implant Dentistry, Faculty of Dentistry, Prince Philip Dental Hospital, The University of Hong Kong, Hong Kong SAR, China.ORCID 0000-0002-2743-0137

Funding

Health and Medical Research Fund of Hong Kong #18170492
6 · The paper itself

Abstract

BACKGROUND AND

aimClinical practice guidelines suggest access flap surgery for managing deep residual pockets after steps 1 and 2 of periodontal therapy. Papilla-preservation flap surgery (PPFS) is the least invasive approach to access and instrument biofilm-contaminated root surfaces. Endoscopic-assisted subgingival debridement (EASD) may enhance the outcomes of repeated instrumentation and provide a minimally invasive non-surgical alternative.

methodsThis was a single-blind, controlled, randomized, parallel-group, non-inferiority 12-month trial comparing EASD with PPFS. Male and female adults with generalized stage III periodontitis and persistent periodontal pockets associated with an intrabony defect after steps 1 and 2 of periodontal therapy were recruited at Prince Philip Dental Hospital. Inter-group differences in clinical attachment level (CAL) changes at 12 months were the primary outcome. Secondary outcomes included pocket resolution (no pocket > 5 mm and no pocket > 4 with bleeding on probing), radiographic bone changes, treatment time, early wound healing and quality-of-life measurements.

resultsSixty-two subjects (30 EASD and 32 PPFS) were included in the intention-to-treat analysis. CAL gains were 2.0 ± 1.0 and 1.8 ± 1.0 mm for test and controls, respectively. The 95% CI of the inter-group difference was -0.3 to 0.8 mm and within the stipulated 1-mm non-inferiority margin. No inter-group differences were observed (i) in pocket resolution, which was achieved in more than 87% of cases for all groups/time points, and (ii) in radiographic bone healing. The treatment time was significantly shorter for EASD than for PPFS. Better early wound healing index scores were observed for EASD. No inter-group differences in pain, quality of life or safety were detected.

conclusionsEASD was not inferior to PPFS for managing residual pockets associated with intrabony defects. The observed outcome profile supports additional developments and studies to validate EASD as an alternative to surgery for isolated persistent pockets (ChiCTR-INR-16008407).

Indexed as

Alveolar Bone LossEndoscopyPeriodontal DebridementPeriodontal PocketSurgical FlapsAdultFemaleHumansMaleMiddle AgedPeriodontal Attachment LossQuality of LifeSingle-Blind MethodTreatment OutcomeWound Healingaccess flap surgeryendoscopy‐assisted visualizationperiodontitisrandomized controlled trialsubgingival debridement

Identifiers

PMID39419270
PMCPMC11743056

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.