Biomaterials Development and Control Center, School of Dentistry, Federal University of Pelotas, Rua Gonçalves Chaves, 457. Centro, Pelotas, RS, CEP: 96015-560, Brazil.
Dental Materials Laboratory, Academic Area of Dentistry, Autonomous University of the State of Hidalgo, Circuito Ex Hacienda La Concepción S/N Carretera Pachuca Actopan, C.P. 42160, San Agustín Tlaxiaca, Hidalgo, Mexico.
Calcif Tissue Int. 2017 Oct;101(4):341-354. doi: 10.1007/s00223-017-0294-z. Epub 2017 Jun 13.
The aim of this study was to evaluate the morphological bone response in animal experiments by applying hydroxyapatite grafts in critical and non-critical size bone defects. Current report followed the guidelines established by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Animal experiments were selected by assessing repair of bone defects with hydroxyapatite as bone graft and with blood clot only as control. Eight articles were identified in specialized literature and included in the meta-analysis. Statistical analysis was carried out with a random-effect model (p = 0.05). Subgroup analyses were further performed to investigate bone repair in critical and non-critical bone defects. Comprehensive analysis of bone repair outcome showed a statistically significant difference between hydroxyapatite and blood clot control (p < 0.05). Subgroup analyses showed statistically significant difference for critical bone defects (p < 0.05). No statistically significant difference was reported in non-critical bone defects (p > 0.05). Although animal studies revealed a high risk of bias and results should be interpreted with caution, the literature suggests that non-critical bone defects may heal spontaneously and without the need of a bone graft. Conversely, when critical-size defects are present, the use of hydroxyapatite bone graft improves the bone repair process.
本研究旨在通过在临界和非临界大小骨缺损中应用羟磷灰石移植物来评估动物实验中的形态骨反应。本报告遵循系统评价和荟萃分析的首选报告项目制定的准则。通过评估羟磷灰石作为骨移植物和仅血凝块作为对照修复骨缺损的动物实验来选择。在专业文献中确定了 8 篇文章并纳入荟萃分析。统计分析采用随机效应模型（p=0.05）。进一步进行亚组分析以研究临界和非临界骨缺损中的骨修复。骨修复结果的综合分析显示羟磷灰石与血凝块对照之间存在统计学显著差异（p<0.05）。亚组分析显示临界骨缺损存在统计学显著差异（p<0.05）。而非临界骨缺损则无统计学显著差异（p>0.05）。尽管动物研究显示存在高偏倚风险，并且结果应谨慎解释，但文献表明非临界骨缺损可能会自发愈合而无需骨移植。相反，当存在临界大小的缺损时，使用羟磷灰石骨移植物可改善骨修复过程。
