Akbarzadeh Baghban Alireza, Dehghani Azam, Ghanavati Farzin, Zayeri Farid, Ghanavati Farzam
Department of Biostatistics, Paramedical School, Iranian Center for Endodontic Research, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Iran Endod J. 2009 Fall;4(4):125-30. Epub 2009 Oct 10.
Bone regeneration grafts (BRG) are widely used in the treatment of osseous defects and oral surgery. The various techniques and associated success rates of bone augmentation require evaluation by systematic review and meta-analysis of eligible studies. The aim of this systematic review was to compare alveolar bone regeneration in humans using Bio-Oss and autogenous bone graft.
The computerized bibliographical databases including Pubmed, Google, ScienceDirect and Cochrane were searched for randomized and cohort studies in which autogenous grafts were compared to Bio-Oss in the treatment of periodontal defects. The inclusion criteria were human studies in English that were published 1998-2009. Exclusion criteria included non randomized observation and cohort studies, papers which provided summary statistics without the variance estimates, and studies that did not use BRG intervention alone, were excluded. The screening of eligible studies, assessment of the methodological quality of the trials and data extraction were collected by two observers independently. For comparing autogenous grafts used alone against Bio-Oss used alone 5 situations were investigated. Thirteen studies were included in the review which compared autogenous against Bio-Oss, autogenous combined with guided tissue regeneration (GTR) against GTR, Bio-Oss combined with GTR versus GTR, autogenous alone versus Open Flap Debridement (OFD), Bio-Oss versus OFD. In meta-analysis, changes in bone level (bone fill) was used as the measure. Data were analyzed using Bayesian meta-analysis by WinBUGS and Boa software.
Only one comparison demonstrated that the difference in bone augmentation between Bio-Oss and OFD was statistically significant.
There is insufficient evidence to show that Bio-Oss is superior to autogenous grafts in bone augmentation techniques however autogenous bone involves donor site surgery and thus donor site morbidity, so we can conclude that Bio-Oss is better than autogenous for alveolar regeneration. [Iranian Endodontic Journal 2009;4(4):125-30].
骨再生移植物（BRG）广泛应用于骨缺损治疗及口腔外科手术。骨增量的各种技术及相关成功率需要通过对符合条件的研究进行系统评价和荟萃分析来评估。本系统评价的目的是比较使用Bio-Oss和自体骨移植物在人类中进行牙槽骨再生的情况。
检索计算机化书目数据库，包括Pubmed、Google、ScienceDirect和Cochrane，查找将自体移植物与Bio-Oss用于治疗牙周缺损的随机和队列研究。纳入标准为1998 - 2009年发表的英文人类研究。排除标准包括非随机观察和队列研究、提供汇总统计数据但无方差估计值的论文，以及未单独使用BRG干预的研究。两名观察者独立进行符合条件研究的筛选、试验方法学质量评估和数据提取。为比较单独使用自体移植物与单独使用Bio-Oss，研究了5种情况。本评价纳入了13项比较自体骨与Bio-Oss、自体骨联合引导组织再生（GTR）与GTR、Bio-Oss联合GTR与GTR、单独自体骨与开放瓣清创术（OFD）、Bio-Oss与OFD的研究。在荟萃分析中，将骨水平变化（骨填充）用作衡量指标。使用WinBUGS和Boa软件通过贝叶斯荟萃分析对数据进行分析。
仅一项比较表明Bio-Oss与OFD在骨增量方面的差异具有统计学意义。
没有足够证据表明在骨增量技术方面Bio-Oss优于自体移植物，然而自体骨涉及供区手术，因此存在供区并发症，所以我们可以得出结论，在牙槽骨再生方面Bio-Oss优于自体骨。[《伊朗牙髓病学杂志》2009年；4(4):125 - 30]
