Clinical performance of access flap in the treatment of class II furcation defects. A systematic review and meta-analysis of randomized clinical trials

Objectives To systematically review the performance of access flap (OFD) in the treatment of class II furcation defects (FD). Methods RCTs evaluating surgical treatment of class II FD with OFD, minimum 6 months follow‐up were identified. Screening, data extraction, and quality assessment were conducted independently by three reviewers. The primary outcomes were tooth survival and change in the horizontal clinical attachment level (HCAL). Changes in vertical clinical attachment level (VCAL), reduction of pocket probing depth (PPD), recession increase (REC), horizontal (HBL), and vertical bone level (VBL) were also collected. Results The search identified 1571 studies out of which 11 articles met the inclusion criteria. Data analysis was performed on 199 patients and 251 FD. Tooth survival was seldom reported. Altogether with inflammatory amelioration, the weighted mean differences were for HCAL 0.96 mm [CI: (0.60, 1.32), p