Lim Glendale, Lin Guo-Hao, Monje Alberto, Chan Hsun-Liang, Wang Hom-Lay
Int J Oral Maxillofac Implants. 2018 January/February;33(1):41–50. doi: 10.11607/jomi.5581. Epub 2017 Sep 22.
The rate of developing soft tissue complications that accompany guided bone regeneration (GBR) procedures varies widely, from 0% to 45%. The present review was conducted to investigate the rate for resorbable versus nonresorbable membranes and the timing of soft tissue complications.
Electronic and manual literature searches were conducted by two independent reviewers using several databases, including MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Cochrane Oral Health Group Trials Register, for articles published through July 2015, with no language restriction. Articles were included if they were clinical trials aimed at demonstrating the incidence of soft tissue complications following GBR procedures.
Overall, 21 and 15 articles were included in the qualitative and quantitative synthesis, respectively. The weighted complication rate of the overall soft tissue complications, including membrane exposure, soft tissue dehiscence, and acute infection/abscess, into the calculation was 16.8% (95% CI = 10.6% to 25.4%). When considering the complication rate based on membrane type used, resorbable membrane was associated with a weighted complication rate of 18.3% (95% CI: 10.4% to 30.4%) and nonresorbable membrane with a rate of 17.6% (95% CI: 10.0% to 29.3%). Moreover, soft tissue lesions were reported as early as 1 week and as late as 6 months based on the included studies.
Soft tissue complications after GBR are common (16.8%). Membrane type did not appear to significantly affect the complication rate, based on the limited number of data retrieved in this study. Technique sensitivity (ie, soft tissue management) may still be regarded as the main component to avoid soft tissue complications and, hence, to influence the success of bone regenerative therapy.
引导骨再生(GBR)手术伴随的软组织并发症发生率差异很大,从0%到45%不等。本综述旨在研究可吸收膜与不可吸收膜的并发症发生率以及软组织并发症的发生时间。
两名独立的审阅者通过电子和手动检索,使用多个数据库,包括MEDLINE、EMBASE、Cochrane对照试验中心注册库和Cochrane口腔健康组试验注册库,检索截至2015年7月发表的文章,无语言限制。纳入的文章需为旨在证明GBR手术后软组织并发症发生率的临床试验。
总体而言,定性和定量分析分别纳入了21篇和15篇文章。纳入计算的总体软组织并发症加权发生率,包括膜暴露、软组织裂开和急性感染/脓肿,为16.8%(95%可信区间=10.6%至25.4%)。根据所用膜的类型考虑并发症发生率时,可吸收膜的加权并发症发生率为18.3%(95%可信区间:10.4%至30.4%),不可吸收膜的发生率为17.6%(95%可信区间:10.0%至29.3%)。此外,根据纳入的研究,软组织病变最早在1周时出现,最晚在6个月时出现。
GBR术后软组织并发症很常见(16.8%)。基于本研究检索到的有限数据,膜的类型似乎并未显著影响并发症发生率。技术敏感性(即软组织管理)可能仍被视为避免软组织并发症从而影响骨再生治疗成功的主要因素。