Hu Ting, Ye Guo, Fan Xiao-Ping, Deng Xue-Yang, Li Wen-Hua, Xiang Xue-Rong
Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences; Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education. Chongqing 401147, China. E-mail:
Shanghai Kou Qiang Yi Xue. 2018 Oct;27(5):546-553.
The aim of this meta analysis was to assess the influence of platelet-rich plasma (PRP)combined with demineralized freeze-dried bone allografts(DFDBA) on regeneration of periodontal periodontal defects by means of evaluating clinical and radiographic outcomes in prospective human clinical trials.
The following databases such as PubMed, The Cochrane Library, EMbase, CNKI, Wanfang data and VIP data were searched on computer from inception to December, 2016. According to the inclusion and exclusion criteria, two reviewers independently extracted the data,assessed the methodological quality of the included studies. RevMan 5.2 was applied for meta analysis.
Six papers were obtained reviewed which included 205 periodontal bone defect sites. Six articles showed that there was no significant difference in probing depth decrease between PRP combined with DFDBA and PRP or DFBDA group[MD=0.35, 95%CI(-0.09,0.79), P=0.12], but there was significant difference in clinical attachment loss increase between the two groups[MD= 0.68,95%CI(0.41,0.94),P<0.00001]. Three articles were included for evaluating bone filling, there was significant difference in the distance from the cemento-enamel junction(CEJ) to the vertical bone defect(BD)(CEJ-BD)[MD=0.71,95%CI(0.46,0.95),P<0.00001]between the two groups; there was also significant difference in the distance from the alveolar crest to the vertical bone defect(AC-BD)[MD=0.64,95%CI(0.41,0.87),P<0.00001]between the two groups. but there was no significant difference in the distance from the cemento-enamel junction(CEJ)to the alveolar crest (AC)(CEJ-AC)[MD=0.03,95%CI(-0.10,0.16),P=0.68] between the two groups.
Within the limitations of this meta analysis, PRP combined with DFDBA is superior to PRP or DFDBA alone in clinical attachment loss and bone filling ,but there was no significant difference in probing depth. However, given the limited sample size and quantity of included studies, the above findings still need to be further proved by conducting more high-quality and large-scale RCTs.
本荟萃分析旨在通过评估前瞻性人体临床试验中的临床和影像学结果,来评估富含血小板血浆(PRP)联合脱矿冻干骨同种异体移植物(DFDBA)对牙周缺损再生的影响。
通过计算机检索PubMed、Cochrane图书馆、EMbase、中国知网、万方数据和维普数据等数据库,检索时间从建库至2016年12月。根据纳入和排除标准,两名研究者独立提取数据,评估纳入研究的方法学质量。采用RevMan 5.2进行荟萃分析。
共纳入6篇文献,涉及205个牙周骨缺损部位。6篇文章显示,PRP联合DFDBA组与PRP组或DFDBA组在探诊深度降低方面无显著差异[MD = 0.35,95%CI(-0.09,0.79),P = 0.12],但两组在临床附着丧失增加方面存在显著差异[MD = 0.68,95%CI(0.41,0.94),P < 0.00001]。纳入3篇文章评估骨填充情况,两组在从牙骨质-釉质界(CEJ)到垂直骨缺损(BD)的距离(CEJ-BD)[MD = 0.71,95%CI(0.46,0.95),P < 0.00001]上存在显著差异;两组在从牙槽嵴到垂直骨缺损(AC-BD)的距离[MD = 0.64,95%CI(0.41,0.87),P < 0.00001]上也存在显著差异。但两组在从牙骨质-釉质界(CEJ)到牙槽嵴(AC)的距离(CEJ-AC)[MD = 0.03,95%CI(-0.10,0.16),P = 0.这68]上无显著差异。
在本荟萃分析的局限性内,PRP联合DFDBA在临床附着丧失和骨填充方面优于单独使用PRP或DFDBA,但在探诊深度方面无显著差异。然而,鉴于纳入研究的样本量和数量有限,上述结果仍需通过开展更多高质量、大规模的随机对照试验来进一步证实。