Degree of Risk of Bias in Randomized Controlled Trials: Does It Have an Impact on Root Coverage Outcomes?

Mustafa Tattan; Katherine S Moore; Leandro Chambrone; Gustavo Avila-Ortiz; Satheesh Elangovan

doi:10.1016/j.jebdp.2021.101526

Degree of Risk of Bias in Randomized Controlled Trials: Does It Have an Impact on Root Coverage Outcomes?

J Evid Based Dent Pract. 2021 Mar;21(1):101526. doi: 10.1016/j.jebdp.2021.101526. Epub 2021 Jan 22.

Authors

Mustafa Tattan¹, Katherine S Moore², Leandro Chambrone³, Gustavo Avila-Ortiz¹, Satheesh Elangovan⁴

Affiliations

¹ Department of Periodontics, The University of Iowa College of Dentistry, Iowa City, IA, USA.
² Dental Student, The University of Iowa College of Dentistry, Iowa City, IA, USA.
³ Department of Periodontics, The University of Iowa College of Dentistry, Iowa City, IA, USA; Evidence-Based Hub, Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz-Cooperativa de Ensino Superior, Caparica, Almada, Portugal; Unit of Basic Oral Investigation (UIBO), Universidad El Bosque, Bogota, Colombia.
⁴ Department of Periodontics, The University of Iowa College of Dentistry, Iowa City, IA, USA. Electronic address: satheesh-elangovan@uiowa.edu.

PMID: 34051960
DOI: 10.1016/j.jebdp.2021.101526

Abstract

Objective: Improvement over time in mean (MRC) and complete root coverage (CRC) reported in randomized controlled trials (RCTs) has been documented. Our objective was to assess the effect that the ROB has on relevant outcomes reported in RCTs evaluating the efficacy of a commonly performed root coverage procedure.

Methods: RCTs that involved the use of a bilaminar technique of coronally advanced flap with connective tissue graft were selected. The following data were extracted: MRC, CRC, whether conflict of interest was addressed (yes/no), adequacy of random sequence generation, allocation concealment, and blinding of outcome assessment. Trials were categorized into four groups as per different time periods: before Consolidated Standards of Reporting Trials (CONSORT) (before 1996), CONSORT (1997 to 2001), CONSORT 2001 (2002 to 2010), and CONSORT 2010 (2011 to 2019). Differences between group means were assessed using statistical analyses.

Results: The search yielded a total of 47 RCTs published between 1993 and 2019 that met the inclusion criteria. A trend toward lower ROB over time in the selected RCTs was observed. However, differences in MRC and CRC with respect to the degree ROB of included trials were not significant.

Conclusions: Degree of ROB did not influence MRC and CRC reported in the RCTs included in this investigation. This finding suggests that the observed improvement of clinical outcomes over time should be attributed to other factors, such as refinement of surgical techniques.

Keywords: Bias; Evidence-based dentistry; Randomized controlled trials; Root coverage.

MeSH terms

Bias*
Connective Tissue*
Humans
Randomized Controlled Trials as Topic*
Research Design*
Surgical Flaps*