Yao Muyun, Hu Jingjing, Jiang Li, Guo Ru, Wang Xuemei
School of Stomatology, Lanzhou University, Lanzhou, China.
Clinical Research Center for Oral Diseases, Lanzhou, China.
Ann Transl Med. 2023 Feb 28;11(4):184. doi: 10.21037/atm-23-891.
Concentrated growth factor (CGF) is a novel biomaterial that can effectively promote tissue growth, but it is uncertain whether adding CGF can product additional effects in the periodontal tissue growth. The purpose of this meta-analysis was to assess the efficacy of CGF combined with grafting materials versus grafting materials alone for the treatment of periodontal intrabony defects.
The PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), China Biology Medicine Disc (CBM), Wanfang, and VIP databases were searched from inception date to June 2022. The inclusion criteria were: (I) randomized controlled trials (RCTs) comparing CGF combined with grafting materials with the single use of grafting materials for the treatment of periodontal intrabony defects, (II) studies providing outcomes of probing depth (PD) and clinical attachment loss (CAL). The literature searches and screening, data extraction, and quality assessment were performed by two reviewers, respectively. The Cochrane bias risk assessment tool was used to assess the quality of the literature. Meta-analysis was performed using Stata 15.0.
A total of 8 randomized controlled trials (RCTs) were obtained, including 150 intrabony defect sites in the combination groups and 153 sites in the control groups. Meta-analysis showed that the combination groups was more effective than the control groups in PD [weighted mean difference (WMD) =-0.73, 95% confidence interval (CI): -0.94, -0.51, P=0.005], CAL (WMD =-0.56, 95% CI: -0.94, -0.19, P=0.003), and bone filling (BF) (WMD =-0.43, 95% CI: -0.65, -0.21, P=0.001), but the difference was not statistically significant between two groups in the change of gingival recession (REC) (WMD =-0.15, 95% CI: -0.44, 0.14, P=0.312). One study presented a high risk of bias due to lost follow-up, and the rest were unclear risk of bias.
For the treatment of periodontal intrabony defects, our meta-analysis showed that CGF combined with grafting materials was more effective than the use of grafting materials alone. However, the findings should be interpreted with caution due to the average quality of RCTs.
浓缩生长因子（CGF）是一种新型生物材料，可有效促进组织生长，但添加CGF是否能对牙周组织生长产生额外效果尚不确定。本荟萃分析的目的是评估CGF联合移植材料与单纯移植材料治疗牙周骨内缺损的疗效。
检索PubMed、Embase、Cochrane图书馆、Web of Science、中国知网（CNKI）、中国生物医学文献数据库（CBM）、万方和维普数据库，检索时间从建库至2022年6月。纳入标准为：（I）比较CGF联合移植材料与单纯使用移植材料治疗牙周骨内缺损的随机对照试验（RCT），（II）提供探诊深度（PD）和临床附着丧失（CAL）结果的研究。文献检索与筛选、数据提取及质量评估分别由两名研究者进行。采用Cochrane偏倚风险评估工具评估文献质量。使用Stata 15.0进行荟萃分析。
共获得8项随机对照试验，联合组有150个骨内缺损部位，对照组有153个部位。荟萃分析显示，联合组在PD[加权均数差（WMD）=-0.73，95%置信区间（CI）：-0.94，-0.51，P=0.005]、CAL（WMD=-0.56，95%CI：-0.94，-0.19，P=0.003）和骨填充（BF）（WMD=-0.43，95%CI：-0.65，-0.21，P=0.001）方面比对照组更有效，但两组在牙龈退缩（REC）变化方面差异无统计学意义（WMD=-0.15，95%CI：-0.44，0.14，P=0.312）。一项研究因失访存在高偏倚风险，其余研究偏倚风险不明。
对于牙周骨内缺损的治疗，我们的荟萃分析表明，CGF联合移植材料比单纯使用移植材料更有效。然而，由于RCT的平均质量，这些结果应谨慎解读。
