使用高密度聚四氟乙烯膜进行拔牙后牙槽嵴保存：系统评价和荟萃分析。
Postextraction ridge preservation by using dense PTFE membranes: A systematic review and meta-analysis.
机构信息
Diplomate of the American Board of Periodontology and Private practice Limited to Periodontics and Implant Dentistry, London, UK; Former Resident, Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minn.
PhD Candidate, Centre for Oral Immunobiology and Regenerative Medicine and Centre for Oral Clinical Research, Institute of Dentistry, Barts & The London School of Medicine and Dentistry, Queen Mary University London (QMUL), London, UK; Diplomate of the American Board of Periodontology and Former Resident, Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minn.
出版信息
J Prosthet Dent. 2024 Mar;131(3):410-419. doi: 10.1016/j.prosdent.2022.02.021. Epub 2022 Apr 9.
STATEMENT OF PROBLEM
The use of dense polytetrafluoroethylene (dPTFE) membranes in alveolar ridge preservation may help reduce the risk of bacterial contamination and infection, maintaining the soft-tissue anatomy. However, systematic reviews on their efficacy in postextraction sites are lacking.
PURPOSE
The purpose of this systematic review and meta-analysis was to assess the efficacy of alveolar ridge preservation with dPTFE membranes when used alone or in combination with bone grafting materials in postextraction sites.
MATERIAL AND METHODS
An electronic search up to February 2021 was conducted by using PubMed, Embase, and the Cochrane library to detect studies using dPTFE membranes in postextraction sites. An additional manual search was performed in relevant journals. Clinical and radiographic dimensional changes of the alveolar ridge, histomorphometric, microcomputed tomography, implant-related findings, and rate of complications were recorded. One-dimensional meta-analysis was performed to calculate the overall means and 95% confidence intervals (α=.05).
RESULTS
A total of 23 studies, 14 randomized controlled trials, 4 retrospective cohort studies, 3 case series, and 2 prospective nonrandomized clinical trials, met the inclusion criteria. Five studies were included in the quantitative analysis. The meta-analysis revealed that the use of dPTFE membranes resulted in a statistically significant (P=.042) increase in clinical keratinized tissue of 3.49 mm (95% confidence interval [CI]: 0.16, 6.83) when compared with extraction alone. Metaregression showed that the difference of 1.10 mm (95% CI: -0.14, 2.35) in the radiographic horizontal measurements was not significant (P=.082), but the difference of 1.06 mm (95% CI: 0.51, 1.62) in the radiographic vertical dimensional change between dPTFE membranes+allograft and extraction alone was statistically significant (P<.001).
CONCLUSIONS
The use of dPTFE membranes was better than extraction alone in terms of keratinized tissue width and radiographic vertical bone loss.
问题陈述
在牙槽嵴保存中使用高密度聚四氟乙烯（dPTFE）膜有助于降低细菌污染和感染的风险，同时维持软组织解剖结构。然而，目前缺乏关于其在拔牙后位点疗效的系统评价。
目的
本系统评价和荟萃分析的目的是评估单独使用 dPTFE 膜或与骨移植材料联合使用在拔牙后位点进行牙槽嵴保存的疗效。
材料与方法
截至 2021 年 2 月，通过 PubMed、Embase 和 Cochrane 图书馆进行电子检索，以检测在拔牙后位点使用 dPTFE 膜的研究。此外，还在相关期刊上进行了手动检索。记录牙槽嵴的临床和放射学维度变化、组织形态计量学、微计算机断层扫描、种植体相关发现和并发症发生率。进行一维荟萃分析以计算总体平均值和 95%置信区间（α=.05）。
结果
共有 23 项研究，14 项随机对照试验、4 项回顾性队列研究、3 项病例系列研究和 2 项前瞻性非随机临床试验符合纳入标准。其中 5 项研究纳入定量分析。荟萃分析显示，与单独拔牙相比，使用 dPTFE 膜可使临床角化组织增加 3.49mm（95%置信区间[CI]：0.16，6.83），差异具有统计学意义（P=.042）。元回归显示，放射学水平测量的差值 1.10mm（95%CI：-0.14，2.35）无统计学意义（P=.082），但 dPTFE 膜+同种异体骨与单独拔牙相比，放射学垂直骨量变化差值 1.06mm（95%CI：0.51，1.62）具有统计学意义（P<.001）。
结论
在角化组织宽度和放射学垂直骨丢失方面，dPTFE 膜的使用优于单独拔牙。
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