de Groot R J, Oomens M A E M, Forouzanfar T, Schulten E A J M
Department of Oral and Maxillofacial Surgery/Special Dental Care, University Medical Center Utrecht, Utrecht, The Netherlands.
Department of Oral and Maxillofacial Surgery, Academic Medical Center (AMC)/Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.
J Oral Rehabil. 2018 Apr;45(4):334-343. doi: 10.1111/joor.12605. Epub 2018 Jan 18.
Long-standing loss of natural teeth in the mandible can lead to severe jaw atrophy and even mandibular fracture. There is no consensus on the best pre-prosthetic surgical treatment to reconstruct the atrophic edentulous mandible. The purpose of this review was to provide an overview of the existing literature and to give an evidence-based recommendation for bone grafting and future research. This systematic review was conducted according to the PRISMA statement. A literature search was performed in online databases Pubmed and Cochrane library for articles published between January 1980 and September 2017. The search was conducted using Medical Subject Heading terms: alveolar ridge augmentation; mouth, edentulous and mandible. Eligible articles were included according to in- and exclusion criteria and assessed on quality. Dental implant survival and bone stability were the primary outcomes. Secondary outcomes were complications. Twenty-four text articles matched the criteria and were included. Eleven articles were assessed to be of adequate quality for analysis. Graft stability seems to be higher in vertical distraction and tent-pole grafting, but as the dental implant survival is high (91.7% or higher) regardless of the procedure used for bone augmentation, this is of no clinical relevance. The survival rate of dental implants is high, regardless of the bone augmentation procedure used. High-quality clinical trials are needed to support the current evidence and guidelines on pre-implant bone grafting. Reporting of future research should include proper baseline characteristics and treatment description, as well as uniform outcome rendering.
下颌骨天然牙长期缺失可导致严重的颌骨萎缩，甚至下颌骨骨折。对于重建萎缩无牙下颌骨的最佳修复前外科治疗方法，目前尚无共识。本综述的目的是概述现有文献，并为骨移植及未来研究提供循证建议。本系统综述是根据PRISMA声明进行的。在在线数据库PubMed和Cochrane图书馆中检索了1980年1月至2017年9月发表的文章。检索使用的医学主题词为：牙槽嵴增高术；无牙口腔和下颌骨。根据纳入和排除标准纳入符合条件的文章，并对质量进行评估。牙种植体存留率和骨稳定性是主要结局。次要结局为并发症。24篇文献符合标准并被纳入。11篇文献被评估质量足以进行分析。垂直牵张和帐篷杆植骨时移植物稳定性似乎更高，但由于无论采用何种骨增量方法牙种植体存留率都很高（91.7%或更高），因此这在临床上并无相关性。无论采用何种骨增量方法，牙种植体的存留率都很高。需要高质量的临床试验来支持目前关于种植前骨移植的证据和指南。未来研究的报告应包括适当的基线特征和治疗描述，以及统一的结局呈现。
