Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland.
Section of Graduate Periodontology, University Complutense, Madrid, Spain.
J Clin Periodontol. 2019 Jun;46 Suppl 21:257-276. doi: 10.1111/jcpe.13050.
To analyse the evidence regarding the efficacy of lateral bone augmentation procedures in terms of defect resolution in cases of horizontal ridge deficiencies after implant placement.
Included studies met the following inclusion criteria: randomized controlled trials (RCTs) or controlled clinical trials (CCTs), re-entry procedure to assess defect resolution, minimum of 10 patients (5 per group). Meta-analyses were performed whenever possible, including subgroup analysis based on membranes and grafting materials.
Twenty-eight publications (20 short-term, 8 follow-up studies) were included. The most often used type of intervention was a xenogeneic particulated grafting material (XE) and a resorbable collagen membrane (CM). The mean defect height at baseline amounted to 5.1 mm (range 2.4-7.8) and decreased to a mean of 0.9 mm (range 0.2-2.2) at re-entry, and the mean defect resolution was 81.3% (range 56.4%-97.1%). Defect height reduction was not significantly different using CM+XE as control treatment compared to the combined data of the respective test groups [n = 11; weighted mean difference (WMD) = -0.006 mm; 95% CI, -0.61, 0.60; p = 0.985]. The absence of any lateral bone augmentation was less favourable than the conjunction of a membrane and a bone grafting material (n = 1; MD = -1.96 mm; 95% CI, -3.48, -0.44; p = 0.011). The lack of a grafting material was less favourable than the conjunction of grafting material and membrane (n = 1; MD = -2.44 mm; 95% CI, -4.53, -0.35; p = 0.022), and the addition of a membrane compared to a grafting material alone was more favourable (n = 3; WMD = 0.97 mm; 95% CI, 0.31, 1.64; p = 0.004).
Lateral bone augmentation is a successful treatment modality. For optimal defect height reduction, a barrier membrane and a grafting material should be combined.
分析在种植体植入后水平骨缺损情况下，侧向骨增量术在解决缺损方面的疗效证据。
纳入的研究符合以下纳入标准：随机对照试验（RCT）或对照临床试验（CCT），重新进入程序以评估缺损的解决情况，每组至少 10 名患者（每组 5 名）。只要有可能，就进行了荟萃分析，包括基于膜和移植物材料的亚组分析。
共纳入 28 篇文献（20 篇短期研究，8 篇随访研究）。最常使用的干预类型是异种颗粒移植物材料（XE）和可吸收胶原膜（CM）。基线时的平均缺损高度为 5.1mm（范围 2.4-7.8），重新进入时降至平均 0.9mm（范围 0.2-2.2），平均缺损分辨率为 81.3%（范围 56.4%-97.1%）。与各自试验组的综合数据相比，CM+XE 作为对照治疗，缺损高度的降低没有显著差异[n=11；加权均数差（WMD）=-0.006mm；95%CI，-0.61，0.60；p=0.985]。与膜和骨移植物联合使用相比，没有任何侧向骨增量的效果较差（n=1；MD=-1.96mm；95%CI，-3.48，-0.44；p=0.011）。与膜联合使用相比，没有移植物材料的效果较差（n=1；MD=-2.44mm；95%CI，-4.53，-0.35；p=0.022），与单独使用移植物材料相比，添加膜更有利（n=3；WMD=0.97mm；95%CI，0.31，1.64；p=0.004）。
侧向骨增量是一种成功的治疗方法。为了获得最佳的缺损高度降低，应将屏障膜和移植物结合使用。
