Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, R. Ramiro Barcelos, 2492, CEP: 90035-003, Porto Alegre, RS, Brazil.
Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, CEP: 13414-903, Piracicaba, SP, Brazil.
Arch Oral Biol. 2021 May;125:105054. doi: 10.1016/j.archoralbio.2021.105054. Epub 2021 Jan 23.
This systematic review aimed to address whether the alveolar socket repair after a tooth extraction is impacted by an osteoporotic phenotype and propose methodological observations.
A search strategy in MEDLINE/PubMed, EMBASE, Web of Science, and Scopus databases was performed. Quality assessment was carried out through the SYRCLE Risk of Bias tool.
Out of the 1147 potentially relevant records, 25 met the inclusion criteria. Most of the studies were performed in rats, and ovariectomy (OVX) was the most frequent osteoporosis induction method. Histomorphometry, micro-computed tomography (microCT), and immunohistochemistry were the main bone repair evaluation methods. Most of the included studies (88 %) presented negative impacts of osteoporosis on the alveolar socket repair. Only three studies (12 %) showed no statistical differences among groups. Overall, most of the quality assessment categories presented a high percentage of unclear risk of bias due to insufficient information in the studies.
The results indicated that an osteoporotic phenotype seems to impair alveolar socket repair after tooth extraction. However, there is still a lack of information and standardization. Therefore, further studies should consider the proposed methodological aspects regarding animal characteristics, OVX associated with a low calcium diet, waiting 8 weeks to osteoporosis induction, maxillary molars as the best option for tooth extraction, confirming and reporting OVX and osteoporosis success, and an appropriate method of repair analysis.
本系统评价旨在探讨骨质疏松表型是否会影响拔牙后牙槽窝的修复，并提出方法学观察。
在 MEDLINE/PubMed、EMBASE、Web of Science 和 Scopus 数据库中进行了搜索策略。通过 SYRCLE 偏倚风险工具进行了质量评估。
在 1147 篇潜在相关记录中，有 25 篇符合纳入标准。大多数研究在大鼠中进行，去卵巢（OVX）是最常见的骨质疏松诱导方法。组织形态计量学、微计算机断层扫描（microCT）和免疫组织化学是主要的骨修复评估方法。大多数纳入的研究（88%）表明骨质疏松对拔牙后牙槽窝修复有负面影响。只有 3 项研究（12%）显示组间无统计学差异。总体而言，由于研究中信息不足，大多数质量评估类别呈现出高比例的不明确偏倚风险。
结果表明，骨质疏松表型似乎会损害拔牙后牙槽窝的修复。然而，目前仍缺乏信息和标准化。因此，进一步的研究应考虑针对动物特征、与低钙饮食相关的 OVX、等待 8 周进行骨质疏松诱导、上颌磨牙作为拔牙的最佳选择、确认和报告 OVX 和骨质疏松成功以及适当的修复分析方法等方面提出的方法学方面。
