Clinical Oral Investigations

, Volume 19, Issue 8, pp 1755–1761 | Cite as

Effect and timing of non-surgical treatment prior to periodontal regeneration: a systematic review

  • Luigi Nibali
  • George Pelekos
  • Olanrewaju Onabolu
  • Nikos Donos



The aim of this systematic review was to assess the study design and reporting of studies on periodontal regeneration, with respect to the effect of the provision of non-surgical periodontal therapy (NSPT) before surgery.

Materials and Methods

A systematic search of the literature was conducted for studies on periodontal regeneration on Medline and EMBASE, complemented by a manual search. Initially, 3310 potentially eligible articles were identified.


A total of 293 studies were included in the review. Nearly 10 % of studies did not include NSPT in the study protocol before regenerative surgery, while 14 % of papers did not report this aspect. Seventy-six percent of studies reported that non-surgical subgingival debridement was performed before periodontal surgery (2 weeks to 6 months before surgery according to the different studies). However, no papers reported clinical and radiographic data before and after NSPT prior to periodontal surgery. Only 45 % of papers reported timing of reassessment following NSPT, prior to proceeding with regenerative surgery.


This review highlights the lack of reporting information on non-surgical periodontal therapy prior to periodontal regenerative surgery, calling for a revision of the current clinical protocols and of the study designs of periodontal regenerative surgery studies.

Clinical relevance

Periodontal regenerative surgery protocols should take into account the possible effects of non-surgical periodontal therapy in the clinical and radiographic healing of intrabony defects.


Regeneration Study design Periodontitis Intrabony defects Non-surgical therapy 



This study was supported by the Periodontal Research Fund of the UCL Eastman Dental Institute, and it was undertaken at UCL, which received a proportion of funding from the Department of Health’s National Institute of Health Research (NIHR) Biomedical Research Centres funding scheme. The authors would like to express sincere thanks to Ms. Anna Di Iorio for her help with the search strategy and retrieval of papers, to Dr. Nikos Mardas for careful review of the manuscript and to Dr. Attila Horvath, Dr. Franky Keijser, Ms. Linda Liu, Mrs. Agnieszka Silka, Ms. Kasia Niziolek and Ms. Marija Rapaic for their help with article translations.

Compliance with ethical standards


No specific funding was received for this review.

Conflict of interest

All authors declare that they have no conflicts of interest in relation to this manuscript.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.

Supplementary material

784_2015_1493_MOESM1_ESM.docx (52 kb)
ESM 1 (DOCX 51 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Luigi Nibali
    • 1
  • George Pelekos
    • 1
    • 2
  • Olanrewaju Onabolu
    • 1
  • Nikos Donos
    • 1
  1. 1.Periodontology Unit and Department of Clinical Research, UCL Eastman Dental InstituteUniversity College LondonLondonUK
  2. 2.Faculty of DentistryUniversity of Hong KongHong Kong SARChina

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