Guida Agostino, Cecoro Gennaro, Rullo Rosario, Laino Luigi, Del Fabbro Massimo, Annunziata Marco
Maxillofacial and ENT Surgery Department, Nationa Cancer Institute -IRCCS "Fondazione G. Pascale", 80131 Naples, Italy.
Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy.
Materials (Basel). 2020 Sep 20;13(18):4180. doi: 10.3390/ma13184180.
The present study aimed to perform a systematic critical appraisal of the methodological quality of systematic reviews (SRs) on the effect of autologous platelet concentrates (APCs) in the treatment of periodontal intraosseous defects and to provide a synthesis of the main clinical findings available. An electronic and hand search was performed up to February 2020; 14 systematic reviews of randomized controlled trials (RCTs), of which 11 were meta-analyses, were included. Only one SR fully satisfied all 11 items of the AMSTAR ("A Measurement Tool to Assess Systematic Reviews") checklist for methodological quality evaluation, 3 SRs were classified of high quality, 8 of medium quality, and 2 of low quality. There is some evidence on the beneficial additive effect of APCs in the surgical treatment of intraosseous defects when used alone or in combination with bone grafts. APCs did not show any advantage when used together with guided tissue regeneration (GTR) or enamel matrix derivative (EMD). Undertaking SRs which adhere to rigorous standards and protocols is strongly recommended. There are increasing data on the positive adjunctive effect of APCs in the surgical treatment of intraosseous defects but, due to the heterogeneity of the available primary studies, the quality of evidence remains rather low and further long-term well-designed RCTs are encouraged.
本研究旨在对关于自体血小板浓缩物(APCs)治疗牙周骨内缺损效果的系统评价(SRs)的方法学质量进行系统的批判性评估,并综合现有的主要临床研究结果。截至2020年2月进行了电子检索和手工检索;纳入了14项随机对照试验(RCTs)的系统评价,其中11项为荟萃分析。只有1项系统评价完全满足用于方法学质量评估的AMSTAR(“评估系统评价的测量工具”)清单的所有11项内容,3项系统评价被归类为高质量,8项为中等质量,2项为低质量。有一些证据表明,APCs单独使用或与骨移植联合使用时,在骨内缺损的外科治疗中具有有益的附加作用。当与引导组织再生(GTR)或釉基质衍生物(EMD)联合使用时,APCs没有显示出任何优势。强烈建议开展符合严格标准和方案的系统评价。关于APCs在骨内缺损外科治疗中的积极辅助作用的数据越来越多,但由于现有原始研究的异质性,证据质量仍然相当低,鼓励进一步开展长期设计良好的随机对照试验。