Hashemi Sara, Tabatabaei Shivasadat, Fathi Amirhossein, Asadinejad Seyedeh Mohadeseh, Atash Ramin
Dental Students Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
School of Public Health, Boston University, Boston, MA, USA.
Eur J Dent. 2024 Feb;18(1):41-54. doi: 10.1055/s-0043-1764420. Epub 2023 Apr 14.
This umbrella review aims to evaluate systematic/meta-analysis studies containing clinical evidence on tooth grafts as bone substitutes in the oral and maxillofacial regions. Using language restrictions and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, an electronic database search of PubMed, MEDLINE, Embase, Cochrane library, and Google Scholar was conducted, featuring published studies up until August 2022. All systematic/meta-analysis review articles relating to tooth graft materials were matched against the inclusion criteria. Two qualified researchers independently assessed the studies' inclusion or exclusion criteria and risk of bias, and a third investigator assisted in resolving ambiguities. A total of 81 systematic/meta-analysis studies, comprising 21 animal-controlled trials, 23 randomized controlled human trials, 23 prospective studies, and 14 retrospective studies, were selected for this study. A small risk of bias was observed in systematic studies/meta-analyses. In addition, the clinical evidence from the analysis of these studies revealed a low incidence of side effects. According to the current review, two systematic reviews indicated that autogenous bone grafting of prepared teeth might be as effective as other bone grafting materials. Four studies also mentioned autologous grafts as potential alternatives to autologous grafts, autogenous demineralized dentin (ADDM), engineered grafts, root blocks, and dental matrix. On the other hand, three systematic studies stated that more long-term research is needed to confirm their findings. Finally, given the importance of standardization and homogeneity of studies for clinical cases, it is advised to be used cautiously due to the risks of transplant rejection.
本伞状综述旨在评估包含口腔颌面部牙齿移植作为骨替代物的临床证据的系统评价/荟萃分析研究。利用语言限制以及系统评价和荟萃分析的首选报告项目（PRISMA）指南，对PubMed、MEDLINE、Embase、Cochrane图书馆和谷歌学术进行了电子数据库检索，纳入截至2022年8月发表的研究。所有与牙齿移植材料相关的系统评价/荟萃分析综述文章均对照纳入标准进行匹配。两名合格的研究人员独立评估研究的纳入或排除标准以及偏倚风险，第三名研究人员协助解决歧义。本研究共纳入81项系统评价/荟萃分析研究，包括21项动物对照试验、23项随机对照人体试验、23项前瞻性研究和14项回顾性研究。在系统评价/荟萃分析中观察到较小的偏倚风险。此外，对这些研究的分析得出的临床证据显示副作用发生率较低。根据当前的综述，两项系统评价表明，预备牙的自体骨移植可能与其他骨移植材料一样有效。四项研究还提到自体移植物可作为自体移植物、自体脱矿牙本质（ADDM）、工程化移植物、牙根块和牙基质的潜在替代品。另一方面，三项系统评价指出，需要更多的长期研究来证实其研究结果。最后，鉴于临床病例研究标准化和同质性的重要性，由于存在移植排斥风险，建议谨慎使用。
