使用磷酸钙或脱蛋白牛骨进行牙种植体窦底提升术的组织学结果:一项系统评价和荟萃分析。
Histological outcomes of sinus augmentation for dental implants with calcium phosphate or deproteinized bovine bone: a systematic review and meta-analysis.
作者信息
Wu J, Li B, Lin X
机构信息
Department of Orthodontics, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Department of Orthodontics, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
出版信息
Int J Oral Maxillofac Surg. 2016 Nov;45(11):1471-1477. doi: 10.1016/j.ijom.2016.04.020. Epub 2016 May 21.
This study compared the histological outcomes of deproteinized bovine bone (DBB) and technically derived calcium phosphate for sinus floor augmentation. MEDLINE, PubMed, Cochrane, EMBASE, and Google Scholar databases were searched until April 2015 with the following key words: dental implants, augmentation/augmented, calcium phosphate/ceramic/tricalcium phosphate, bovine bone/Bio-Oss, deproteinized/anorganic. Randomized controlled trials (RCTs) and two-arm prospective/retrospective studies that used DBB or biphasic calcium phosphate/tricalcium phosphate (BCP/TCP) for sinus augmentation with quantitative results were included. Outcomes were the percentage of new bone formed and percentage of surface contact between the graft material and new bone (bone-to-graft contact). Four RCTs and one prospective study were included, with a total of 110 patients and 145 implants. All studies reported the percentage of new vital bone; however, large heterogeneity was present (Q=15.23, P=0.004, I=73.8%). BCP/TCP was associated with a higher percentage of new bone, but the pooled results did not reach significance (pooled standardized mean difference (SMD)=0.145, 95% confidence interval (CI) -0.488 to 0.778, P=0.654). Only two studies reported bone-to-graft contact, and BCP/TCP was associated with significantly lower bone-to-graft contact (pooled SMD=-0.807, 95% CI -1.276 to -0.337, P=0.001). This meta-analysis does not allow us to conclude superiority of one particular material with respect to histological outcomes.
本研究比较了脱蛋白牛骨(DBB)和工业生产的磷酸钙用于上颌窦底提升的组织学结果。检索MEDLINE、PubMed、Cochrane、EMBASE和谷歌学术数据库至2015年4月,检索关键词如下:牙种植体、增量/增高、磷酸钙/陶瓷/磷酸三钙、牛骨/骨替代材料、脱蛋白/无机。纳入采用DBB或双相磷酸钙/磷酸三钙(BCP/TCP)进行上颌窦增量并具有定量结果的随机对照试验(RCT)和双臂前瞻性/回顾性研究。观察指标为新形成骨的百分比以及移植材料与新骨之间的表面接触百分比(骨与移植材料接触)。纳入了4项RCT和1项前瞻性研究,共110例患者和145枚种植体。所有研究均报告了新生活性骨的百分比;然而,存在较大异质性(Q=15.23,P=0.004,I=73.8%)。BCP/TCP组新骨百分比更高,但合并结果未达到显著差异(合并标准化均数差(SMD)=0.145,95%置信区间(CI)-0.488至0.778,P=0.654)。仅有两项研究报告了骨与移植材料接触情况,BCP/TCP组骨与移植材料接触显著更低(合并SMD=-0.807,95%CI-1.276至-0.337,P=0.001)。本荟萃分析无法让我们得出一种特定材料在组织学结果方面具有优越性的结论。