Amine Khadija, Radaj Youssef, Gharibi Amina, Kissa Jamila
Department of Periodontics, Faculty of Dentistry, University Hassan II of Casablanca, Morocco.
Faculty of Dentistry, University Hassan II of Casablanca, Morocco.
Front Dent. 2020 Dec 25;17:38. doi: 10.18502/fid.v17i38.5291. eCollection 2020.
The aim of this systematic review was to assess the clinical efficacy of bone regeneration for treatment of peri-implantitis.
Electronic search of the literature was performed to identify randomized clinical trials (RCTs) and case series on treatment of peri-implantitis using bone regeneration procedures with at least 6 months of follow-up. The guidelines of the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) were applied. The risk of bias was assessed using the Cochrane Collaboration's Risk of Bias tool.
Two RCTs and 16 case series with a total of 520 treated patients (2002 implants) were included. Bone regenerative procedures showed controversial results regarding bone fill. Two studies reported statistically significant bone gain while four studies reported insignificant bone gain. Other studies reported bone gain with no P value. Pocket depth (PD) reduction varied among the studies since four studies reported a significant reduction in PD while four others reported insignificant reduction in PD. Other studies reported a reduction in PD with no P value. Bone regeneration procedures seemed to decrease bleeding on probing (BOP) but they did not seem conducive to increase the width of keratinized gingiva. Increased keratinized gingiva was noted in cases with subepithelial grafts.
Evaluation of the effectiveness of bone regeneration techniques in this systematic review presented limitations related to heterogeneity in patient selection (age, history of periodontitis, smoking status and implant system), means of disinfection and decontamination, and variability of the materials used for treatment.
本系统评价旨在评估骨再生治疗种植体周围炎的临床疗效。
通过电子检索文献，以识别使用骨再生程序治疗种植体周围炎且随访至少6个月的随机临床试验（RCT）和病例系列。应用了系统评价和Meta分析的首选报告项目（PRISMA）指南。使用Cochrane协作网的偏倚风险工具评估偏倚风险。
纳入了两项RCT和16个病例系列，共520例接受治疗的患者（2002颗种植体）。骨再生程序在骨填充方面显示出有争议的结果。两项研究报告了有统计学意义的骨增量，而四项研究报告骨增量无统计学意义。其他研究报告了骨增量但未给出P值。各研究中牙周袋深度（PD）的降低情况各不相同，四项研究报告PD有显著降低，而另外四项研究报告PD降低无统计学意义。其他研究报告了PD降低但未给出P值。骨再生程序似乎减少了探诊出血（BOP），但似乎不利于增加角化龈宽度。在使用上皮下移植的病例中观察到角化龈增加。
在本系统评价中，对骨再生技术有效性的评估存在局限性，这些局限性与患者选择的异质性（年龄、牙周炎病史、吸烟状况和种植系统）、消毒和去污方法以及治疗所用材料的变异性有关。
