Department of Oral and Maxillofacial Surgery, Dental Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Int J Oral Maxillofac Implants. 2013 Jul-Aug;28(4):1076-89. doi: 10.11607/jomi.2925.
The aim of this study was to assess the effectiveness of barrier membranes in bone augmentation through a systematic review of the literature.
Electronic data banks and hand searching were used to find relevant articles on the reconstruction of localized bone defects published up to May 2011. Controlled animal and human studies with more than 4 weeks of follow-up were included; studies of periodontal lesions, extraction sockets, and maxillary sinus grafts were excluded. Applications of recombinant growth factor or assessments of membranes' effects on implant osseointegration were also considered exclusion criteria. Defects filled with bone graft/bone substitute material and covered with a membrane were considered the test group, while uncovered defects were considered the control group. Thereafter, human and animal studies were evaluated separately by meta-analysis.
Of the 3,986 articles found in the initial search, 34 studies met the inclusion criteria. Four animal studies concluded that the use of barrier membranes would increase the amount of vertical augmented bone (mean difference 0.32 mm; P = .006). Qualitative results regarding horizontal bone augmentation were controversial. Membranes do not increase the risk of improper healing, according to both human studies (odds ratio 5.67; P = .32) and animal studies (odds ratio 3.35; P = .12).
There is limited evidence to support the effectiveness of barrier membranes in the treatment of bone deficiencies. Membranes do not increase postoperative infection, wound dehiscence, or membrane/bone graft exposure in either human or animal models. Because a majority of the results are based on animal studies, more randomized clinical trials are needed to objectively measure the efficacy of membranes in human bone augmentation.
本研究旨在通过对文献的系统回顾，评估屏障膜在骨增量中的有效性。
电子数据库和手工检索用于查找截至 2011 年 5 月发表的有关局部骨缺损重建的相关文章。纳入了具有超过 4 周随访的对照动物和人体研究；排除了牙周病、拔牙窝和上颌窦植骨的研究。应用重组生长因子或评估膜对种植体骨整合影响的研究也被视为排除标准。用骨移植/骨替代材料填充并覆盖膜的缺损被视为实验组，而未覆盖的缺损被视为对照组。然后，通过meta 分析分别对人体和动物研究进行评估。
在最初的搜索中发现了 3986 篇文章，其中 34 项研究符合纳入标准。四项动物研究的结论是使用屏障膜会增加垂直骨增量的量（平均差异 0.32mm；P=0.006）。关于水平骨增量的定性结果存在争议。根据人体研究（比值比 5.67；P=0.32）和动物研究（比值比 3.35；P=0.12），膜不会增加不当愈合的风险。
有有限的证据支持屏障膜在治疗骨缺损方面的有效性。在人体和动物模型中，膜不会增加术后感染、伤口裂开或膜/骨移植物暴露的风险。由于大多数结果都是基于动物研究，因此需要更多的随机临床试验来客观测量膜在人体骨增量中的疗效。
