Delgado-Ruiz Rafael Arcesio, Calvo Guirado José Luis, Romanos Georgios E
Department of Prosthodontics and Digital Technology, Stony Brook University, Stony Brook, NY, USA.
International Dentistry Research Cathedra, San Antonio Catholic University of Murcia (UCAM), Murcia, Spain.
Clin Oral Implants Res. 2018 Jun;29(6):620-634. doi: 10.1111/clr.12614. Epub 2015 May 20.
To perform a systematic literature review of the regenerative potential of bone substitutes used to fill critical size defects (CSDs) in rabbit calvariae; to determine the quality of the included studies using ARRIVE guidelines.
An Internet search was performed in duplicate using MEDLINE, PubMed and Google Scholar databases (without restrictions on publication date) for studies reporting the regenerative potential of bone substitutes in CSDs in rabbit calvariae. Four parameters were analyzed by histomorphometry: new bone formation (NB); defect closure (DC); residual graft (RG); and connective tissue (CT). Animal Research Reporting in In Vivo Experiments (ARRIVE) guidelines (a list of 20 aspects for scoring texts and ensuring comparison between different experimental studies in animals) were used to evaluate the quality of the selected works.
Twenty-one manuscripts were included. CSDs with 15 mm were predominant (57.14%). Only one study described the four histomorphometric parameters. NB formation was analyzed in 15 studies (71.42%) and was higher for particulate autogenous bone grafts (range 52.1-82%) after 12 weeks. DC was evaluated in six studies (28.57%) and was higher for fragmented adipose tissue grafts (range 53.33-93.33%) after 12 weeks. RG was evaluated in four studies (19.04%) and was higher for hydroxyapatite/beta-tricalcium phosphate grafts with silica (HA/ß-TCP + Si) (range 35.78-47.54%) at 12 weeks. CT was evaluated in two studies (9.5%) and was higher for HA/ß-TCP + membrane (44.2%) at 12 weeks. Quality evaluation identified three items (title, introduction/objectives and experimental procedure) (15%) with excellent scores, 10 items (abstract, introduction/background, methods/ethical statement, experimental animals, experimental outcomes, statistics, results/baseline data, outcome/estimation and discussion interpretation/scientific implications) (50%) with average scores, and seven items (housing and husbandry, sample size, allocation, numbers analyzed, adverse effects, general applicability/relevance and funding) (35%) obtained poor scores. Only one manuscript obtained a quality evaluation considered as excellent.
Autogenous bone grafts increase NB. DC is enhanced by the use of fragmented adipose tissue. RG remains in the defect for longer when hydroxyapatite/beta-tricalcium phosphate with silica is used, and more CT can be expected when hydroxyapatite/beta-tricalcium phosphate with silica grafts are covered by a membrane. The addition of stem cells of different origins to grafting materials enhances bone formation in early healing periods. The ARRIVE guidelines are still insufficiently used and the overall quality of studies remains low.
对用于填充兔颅骨临界尺寸骨缺损（CSD）的骨替代物的再生潜力进行系统的文献综述；使用ARRIVE指南确定纳入研究的质量。
使用MEDLINE、PubMed和谷歌学术数据库进行了两次重复的互联网搜索（不受出版日期限制），以查找报告兔颅骨CSD中骨替代物再生潜力的研究。通过组织形态计量学分析了四个参数：新骨形成（NB）；缺损闭合（DC）；残余移植物（RG）；以及结缔组织（CT）。使用动物体内实验研究报告（ARRIVE）指南（一份用于对文本评分并确保不同动物实验研究之间可比性的20个方面的列表）来评估所选研究的质量。
纳入了21篇手稿。15毫米的CSD占主导（57.14%）。只有一项研究描述了这四个组织形态计量学参数。15项研究（71.42%）分析了NB形成，12周后颗粒状自体骨移植物的NB形成更高（范围为52.1 - 82%）。六项研究（28.57%）评估了DC，12周后破碎脂肪组织移植物的DC更高（范围为53.33 - 93.33%）。四项研究（19.04%）评估了RG，12周时含二氧化硅的羟基磷灰石/β - 磷酸三钙移植物（HA/β - TCP + Si）的RG更高（范围为35.78 - 47.54%）。两项研究（9.5%）评估了CT，12周时HA/β - TCP + 膜的CT更高（44.2%）。质量评估发现三项（标题、引言/目的和实验程序）（15%）得分优秀，十项（摘要、引言/背景、方法/伦理声明、实验动物、实验结果、统计学、结果/基线数据、结果/估计和讨论解释/科学意义）（50%）得分中等，七项（饲养管理、样本量、分配、分析数量、不良反应、一般适用性/相关性和资金）（35%）得分较差。只有一篇手稿获得了被认为优秀的质量评估。
自体骨移植物可增加NB。使用破碎脂肪组织可增强DC。使用含二氧化硅的羟基磷灰石/β - 磷酸三钙时，RG在缺损中留存时间更长，当含二氧化硅的羟基磷灰石/β - 磷酸三钙移植物被膜覆盖时，可预期有更多的CT。在移植材料中添加不同来源的干细胞可在愈合早期增强骨形成。ARRIVE指南的使用仍然不足，研究的整体质量仍然较低。
