Vajgel André, Mardas Nikos, Farias Bruna Carvalho, Petrie Aviva, Cimões Renata, Donos Nikolaos
Oral and Maxillofacial Department, University of Pernambuco (FOP/UPE), Recife, Brazil; CAPES Foundation, Ministry of Education of Brazil, Brasília, Brazil; Periodontology Unit, UCL Eastman Dental Institute, London, UK.
Clin Oral Implants Res. 2014 Aug;25(8):879-93. doi: 10.1111/clr.12194. Epub 2013 Jun 7.
To systematically review the literature data regarding the critical size defect (CSD) in adult rat calvaria and to determine which defect dimensions could be considered as being critical size.
A literature search was conducted at Ovid Medline and Embase up to July 2012. Studies presenting with at least one of the primary outcomes of interest (number of defects with complete closure and the percentage of new bone formation (%NBF) in rat calvaria) were included. Screening, data extraction and quality assessment were conducted independently and in duplicate.
From 1461 citations, 257 full-text papers were screened and 61 papers were included in the analysis. Fourteen of 937 evaluated defects presented complete closure. Only 7 and 6 untreated sites in 5.0- and 6.0-mm-diameter defects, respectively, showed complete closure. A great variability among the preclinical models was seen, and the meta-analysis result showed a high heterogeneity regarding the mean %NBF. The mean %NBF according to the defect dimension was as follows: 18.29% and 21.44% for 5.0 mm central single defects at 1 and 3 months, respectively; 17.55%, 20.24% and 22.65% for 5.0 mm bilateral defects; 9.81%, 12.56% and 7.96% for 8.0 mm single defect; 11.18%, 9.48% and 26.24% for 9.0 mm single defects at 1, 2 and 3 months, respectively.
Calvarial defects with a diameter of 5.0 mm could be considered as a CSD. However, there is a necessity for further standardization of the rat calvaria model to enable more accurate comparison among future studies.
系统回顾有关成年大鼠颅骨临界大小缺损（CSD）的文献数据，并确定哪些缺损尺寸可被视为临界大小。
截至2012年7月，在Ovid Medline和Embase上进行文献检索。纳入至少呈现一项主要关注结果（大鼠颅骨缺损完全闭合的数量以及新骨形成百分比（%NBF））的研究。筛选、数据提取和质量评估均独立且重复进行。
从1461篇引用文献中，筛选出257篇全文论文，61篇论文纳入分析。937个评估缺损中有14个呈现完全闭合。在直径5.0毫米和6.0毫米的缺损中，分别只有7个和6个未治疗部位显示完全闭合。临床前模型之间存在很大差异，荟萃分析结果显示平均%NBF存在高度异质性。根据缺损尺寸的平均%NBF如下：1个月和3个月时，5.0毫米中央单一缺损分别为18.29%和21.44%；5.0毫米双侧缺损为17.55%、20.24%和22.65%；8.0毫米单一缺损为9.81%、12.56%和7.96%；1个月、2个月和3个月时，9.0毫米单一缺损分别为11.18%、9.48%和26.24%。
直径5.0毫米的颅骨缺损可被视为临界大小缺损。然而，有必要进一步标准化大鼠颅骨模型，以便未来研究之间能进行更准确的比较。
