University "Gabriele D'Annunzio" of Chieti-Pescara, 66100 Chieti, Italy.
IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy.
Int J Mol Sci. 2019 Aug 28;20(17):4221. doi: 10.3390/ijms20174221.
This systematic review is aimed at evaluating the effectiveness of synthetic block materials for bone augmentation in preclinical in vivo studies. An electronic search was performed on Pubmed, Scopus, EMBASE. Articles selected underwent risk-of-bias assessment. The outcomes were: new bone formation and residual graft with histomorphometry, radiographic bone density, soft tissue parameters, complications. Meta-analysis was performed to compare new bone formation in test (synthetic blocks) vs. control group (autogenous blocks or spontaneous healing). The search yielded 214 articles. After screening, 39 studies were included, all performed on animal models: rabbits ( = 18 studies), dogs ( = 4), rats ( = 7), minipigs ( = 4), goats ( = 4), and sheep ( = 2). The meta-analysis on rabbit studies showed significantly higher new bone formation for synthetic blocks with respect to autogenous blocks both at four-week (mean difference (MD): 5.91%, 95% confidence intervals (CI): 1.04, 10.79%, = 0.02) and at eight-week healing (MD: 4.44%, 95% CI: 0.71, 8.17%, = 0.02). Other animal models evidenced a trend for better outcomes with synthetic blocks, though only based on qualitative analysis. Synthetic blocks may represent a viable resource in bone regenerative surgery for achieving new bone formation. Differences in the animal models, the design of included studies, and the bone defects treated should be considered when generalizing the results. Clinical studies are needed to confirm the effectiveness of synthetic blocks in bone augmentation procedures.
本系统评价旨在评估合成块状材料在临床前体内研究中用于骨增量的有效性。我们在 Pubmed、Scopus 和 EMBASE 上进行了电子检索。选择的文章进行了风险偏倚评估。结果为：新骨形成和组织形态计量学的残留移植物、放射影像学骨密度、软组织参数、并发症。我们进行了荟萃分析，以比较实验组（合成块）和对照组（自体块或自发愈合）的新骨形成。检索产生了 214 篇文章。经过筛选，共纳入 39 项研究，均在动物模型中进行：兔（= 18 项研究）、狗（= 4 项）、大鼠（= 7 项）、小型猪（= 4 项）、山羊（= 4 项）和绵羊（= 2 项）。兔研究的荟萃分析显示，与自体块相比，合成块在四周（平均差异（MD）：5.91%，95%置信区间（CI）：1.04，10.79%， = 0.02）和八周愈合（MD：4.44%，95% CI：0.71，8.17%， = 0.02）时的新骨形成明显更高。其他动物模型也表明，合成块的结果更好，尽管只是基于定性分析。在实现新骨形成方面，合成块可能是骨再生手术中一种可行的资源。在推广结果时，应考虑动物模型、纳入研究的设计以及治疗的骨缺损的差异。需要进行临床研究以确认合成块在骨增量程序中的有效性。
