Xue Wei, Xiaobo Zhong, Bin He, Yanhan Deng, Shumei Luo
Dept. of Stomatology, The People's Hospital in Zheng' an County, Zunyi City, Zunyi 563000, China.
Dept. of Conservative Dentistry and Endodontics, Stomatological Hospital of Chongqing Medical University, Chongqing 401147, China.
Hua Xi Kou Qiang Yi Xue Za Zhi. 2017 Dec 1;35(6):636-642. doi: 10.7518/hxkq.2017.06.014.
This review aims to systematically evaluate the effect of decalcified freeze-dried bone allograft (DFDBA) combined with rich platelet derivatives on the treatment of human periodontal intrabony defects.
A search in PubMed, Web of Science, Embase, Cochrane Library, CNKI, and other electronic databases was conducted to identify randomized controlled trials (RCT) of the use of DFDBA combined with rich platelet derivatives in the treatment of human periodontal intrabony defects, performed before May 2016. The quality of the RCTs was assessed. RevMan 5.3 software was applied for Meta-analysis.
RESULTS: A total of nine RCTs were included. A total of 194 patients and 303 defects were involved. Short-term (6 months) and long-term (12 to 18 months) groups were included. Meta-analysis results revealed that DFDBA combined with rich platelet derivatives was superior to DFDBA or rich platelet derivatives alone for probing depth reduction in the short-term [MD=0.75 mm, 95% confidence intervals (CI) (0.31 mm, 1.20 mm), P=0.001 0] and longterm groups [MD=0.87 mm, 95%CI (0.02 mm, 1.72 mm), P=0.04], clinical attachment level gain in the short-term [MD= 0.65 mm, 95%CI (0.08 mm, 1.22 mm), P=0.03] and long-term groups [MD=1.31 mm, 95%CI (0.60 mm, 2.01 mm), P<0.000 3], gingival recession reduction in the long-term group [MD=-0.58 mm, 95%CI (-0.78 mm, -0.38mm), P<0.000 01], bone fill gain in the short-term [MD=0.52 mm, 95%CI (0.03 mm, 1.00 mm), P=0.04] and long-term groups [MD=1.26 mm, 95%CI (0.65 mm, 1.86 mm), P<0.000 1].
DFDBA combined with platelet rich derivatives is probably effective in the treatment of human periodontal intrabony defects. It is probably superior to DFDBA or platelet rich derivatives alone. Considering the limitation of the included studies, high-quality and large-sample RCTs are required to evaluate the effect.
本综述旨在系统评价脱钙冻干骨同种异体移植(DFDBA)联合富血小板衍生物治疗人类牙周骨内缺损的效果。
检索PubMed、Web of Science、Embase、Cochrane图书馆、中国知网等电子数据库,以识别2016年5月之前进行的关于DFDBA联合富血小板衍生物治疗人类牙周骨内缺损的随机对照试验(RCT)。评估RCT的质量。应用RevMan 5.3软件进行Meta分析。
共纳入9项RCT。共涉及194例患者和303处缺损。纳入短期(6个月)和长期(12至18个月)组。Meta分析结果显示,DFDBA联合富血小板衍生物在短期[平均差(MD)=0.75mm,95%置信区间(CI)(0.31mm,1.20mm),P=0.0010]和长期组[MD=0.87mm,95%CI(0.02mm,1.72mm),P=0.04]中,在探诊深度降低方面优于单独使用DFDBA或富血小板衍生物;在短期[MD=0.65mm,95%CI(0.08mm,1.22mm),P=0.03]和长期组[MD=1.31mm,95%CI(0.60mm,2.01mm),P<0.0003]中,在临床附着水平增加方面也更优;在长期组中,在牙龈退缩减少方面[MD=-0.58mm,95%CI(-0.78mm,-0.38mm),P<0.00001]更优;在短期[MD=0.52mm,95%CI(0.03mm,1.00mm),P=0.04]和长期组[MD=1.26mm,95%CI(0.65mm,1.86mm),P<0.0001]中,在骨填充增加方面更优。
DFDBA联合富血小板衍生物可能对治疗人类牙周骨内缺损有效。它可能优于单独使用DFDBA或富血小板衍生物。考虑到纳入研究的局限性,需要高质量、大样本的RCT来评估其效果。