Department of Clinical and Experimental Medicine, Foggia University, Foggia, Italy.
Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, Naples, Italy.
J Periodontol. 2018 Jan;89(1):46-57. doi: 10.1902/jop.2017.170241.
Alveolar ridge preservation (ARP) techniques aim to reduce resorption after tooth extraction. The combination of a graft material covered with a resorbable membrane represents one of the most common strategies performed in the clinical practice. The aim of this systematic review is to analyze evidence regarding potential benefits of ARP procedures performed with allogenic/xenogenic grafts in combination with a resorbable membrane coverage in comparison with spontaneous healing.
Electronic databases were screened independently to select studies suitable for inclusion in this review. Horizontal ridge width reduction (HRWR) and vertical ridge height reduction (VRHR) were investigated as primary outcomes and volume changes (VC) as a secondary outcome. Meta-analysis was performed using the inverse of variance test with a random effect model. Adjustment for Type I and II errors and analysis of the power of evidence was performed with trial sequential analysis (TSA).
Seven studies met the inclusion criteria and were included in the quantitative synthesis. Meta-analysis revealed that the combination therapy resulted in a lower rate of resorption for both HRWR (-2.19 mm, 95% confidence interval [CI]: -2.67 to -1.71 mm) and VRHR (-1.72 mm, 95% CI: -2.14 to -1.30 mm). For VC no meta-analysis was performed due to insufficient data. Analysis of the power of the evidence performed with TSA showed that the number of both studies and sockets analyzed is sufficient to validate such findings, despite the high rate of heterogeneity.
Use of bone graft covered by a resorbable membrane can decrease the rate of alveolar ridge horizontal and vertical resorption after tooth extraction. The power and reliability of the evidence is strong enough to confirm the above-mentioned findings, despite the high rate of heterogeneity of included studies.
牙槽嵴保存（ARP）技术旨在减少拔牙后吸收。将移植物材料与可吸收膜结合使用是临床实践中最常见的策略之一。本系统评价的目的是分析使用同种异体/异种移植物与可吸收膜覆盖相结合的 ARP 程序与自发愈合相比在潜在获益方面的证据。
电子数据库被独立筛选，以选择适合纳入本综述的研究。水平牙槽嵴宽度减少（HRWR）和垂直牙槽嵴高度减少（VRHR）被作为主要结局，体积变化（VC）被作为次要结局进行研究。使用逆方差检验和随机效应模型进行荟萃分析。使用试验序贯分析（TSA）对Ⅰ型和Ⅱ型错误的调整和证据效力的分析进行了调整。
有 7 项研究符合纳入标准并被纳入定量综合分析。荟萃分析表明，联合治疗在 HRWR（-2.19 毫米，95%置信区间[CI]：-2.67 至-1.71 毫米）和 VRHR（-1.72 毫米，95% CI：-2.14 至-1.30 毫米）方面均导致吸收减少。由于数据不足，未对 VC 进行 meta 分析。使用 TSA 进行的证据效力分析表明，尽管存在高度异质性，但分析的研究数量和分析的窝数量足以验证这些发现。
使用可吸收膜覆盖的骨移植物可以减少拔牙后牙槽嵴水平和垂直吸收的速度。尽管纳入研究的异质性很高，但证据的力度和可靠性足以确认上述发现。
