Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
Charité Centre for Dental Medicine, Department of Oral Diagnostics and Digital Health and Health Services Research, Charité-Universitätsmedizin Berlin, Berlin, Germany.
J Clin Periodontol. 2022 Jul;49(7):694-705. doi: 10.1111/jcpe.13628. Epub 2022 Apr 29.
To evaluate the efficacy of different techniques to seal the alveolus (flap advancement [FA], open healing with barrier [OHB], and open healing without barrier [OHNB]) during alveolar ridge preservation (ARP) in terms of horizontal ridge width resorption.
Randomized trials of at least 2 months duration comparing at least two techniques to seal the alveolus against each other or against spontaneous healing (SH) were eligible. Searches were conducted in MEDLINE via PubMed, EMBASE, Scopus, and Cochrane Central. Conventional meta-analysis, meta-regression, and network meta-analysis (NMA) were conducted, with clinical and tomographic ridge width changes as outcomes. Predictive intervals (95% PI) were reported.
Twenty-two studies were included, accounting for 52 study arms. Meta-regression identified that the socket sealing technique and publication year explained the observed heterogeneity. NMA showed that FA and OHB led to significantly lower ridge resorption than SH, resulting in 1.18 mm (95% PI 0.21-2.13) and 1.10 mm (95% PI 0.49-1.69) wide alveolar ridges, respectively. No significant difference between OHNB and SH was found (0.46 mm, 95% PI -0.70 to 1.64). The treatment with the largest probability for ARP was FA (52.7%), followed by OHB (39.1%) and OHNB (8.2%).
FA and OHB are efficacious techniques to seal the alveolus during ARP.
评估在牙槽嵴保存（ARP）中，不同技术（瓣推进术[FA]、开放式愈合加屏障[OHB]和开放式愈合无屏障[OHNB]）封闭牙槽的效果，以评估水平牙槽嵴宽度吸收情况。
本研究为至少 2 个月的随机试验，比较了至少两种技术彼此之间或与自发性愈合（SH）的效果。通过 MEDLINE 下的 PubMed、EMBASE、Scopus 和 Cochrane Central 进行检索。采用常规的荟萃分析、荟萃回归和网络荟萃分析（NMA），以临床和影像学的牙槽嵴宽度变化为结局。报告预测区间（95%PI）。
共纳入 22 项研究，共计 52 个研究臂。荟萃回归确定，牙槽窝封闭技术和发表年份解释了观察到的异质性。NMA 显示，FA 和 OHB 导致的牙槽嵴吸收明显低于 SH，分别为 1.18mm（95%PI 0.21-2.13）和 1.10mm（95%PI 0.49-1.69）宽的牙槽嵴。OHNB 与 SH 之间无显著差异（0.46mm，95%PI -0.70 至 1.64）。ARP 中最有可能的治疗方法是 FA（52.7%），其次是 OHB（39.1%）和 OHNB（8.2%）。
FA 和 OHB 是 ARP 中封闭牙槽的有效技术。
