Clinical efficacy of periosteal pedicle graft as a barrier membrane in guided tissue regeneration: A systematic review and meta-analysis

The study aims to assess the clinical efficacy of periosteal pedicle graft (PPG) as a barrier membrane in guided tissue regeneration (GTR) for gingival recession, intrabony, and furcation defects. Electronic and hand searches were performed to identify randomized controlled/clinical trials investigating GTR using PPG, with 6-month follow-up. Primary outcomes recorded: probing depth (PD), clinical attachment level (CAL), bone fill, recession depth (RD) reduction, percentage of mean root coverage, keratinized tissue width (KTW), and bone defect area (BDA). Thirteen articles were selected; 6 for recession, 2 for furcation, and 5 for intrabony. Meta-analysis was performed whenever possible, results expressed as pooled standardized mean differences (SMDs). In recession defects, the RD pooled SMD is 0.47 (95% confidence interval (CI) = [-0.50-1.44]), KTW pooled SMD is 1.30 (95% CI = [-0.30-2.91]), favoring PPG over the comparator. In furcation defects, PD pooled SMD is 1.12 (95% CI = [-2.77-0.52]), CAL pooled SMD is 0.71 (95% CI = [-1.09-2.50]), and bone fill pooled SMD is 0.67 (95% CI = [-3.34-4.69]) favoring PPG. In intrabony defects, PD pooled SMD is 0.54 (95% CI = [-2.12-1.04]), CAL pooled SMD is 0.23 (95% CI = [-1.13-0.68]), and BDA pooled SMD is 0.37 (95% CI = [-1.58-2.31]) favoring PPG. The results were not statistically significant. The current evidence indicates that PPG constitutes a valid and reliable alternative to collagen barrier membranes for successful GTR.