Department of Endodontics, Jinan Stomatological Hospital, Jinan, China.
Department of Prosthodontics, Jinan Stomatological Hospital, Jinan, China.
Int Wound J. 2023 Dec;20(10):4340-4348. doi: 10.1111/iwj.14293. Epub 2023 Jul 12.
A meta-analysis was performed to assess the effects of different regenerative technologies and materials on wound healing after surgical endodontic therapy and provide a reference for surgical endodontic treatment. We searched for studies on the use of regenerative technologies and materials in surgical endodontic therapy via PubMed, MEDLINE, EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang Data from the time of database creation to December 2022. Two researchers independently screened the literature, extracted information based on the inclusion and exclusion criteria, and evaluated the quality of the included studies. A meta-analysis was performed using Review Manager 5.4. The results showed that the use of regenerative technologies and materials significantly reduced wound healing failures (risk ratio [RR]: 0.30, 95% confidence intervals [CI]: 0.22-0.40, p < 0.001). Moreover, autologous platelet concentrations (APCs) (RR: 0.28, 95% CI: 0.15-0.53, p < 0.001) and collagen membrane plus bovine-derived hydroxyapatite (RR: 0.27, 95% CI. 0.12-0.61, p = 0.002) were more effective in improving wound healing failure rates than collagen membrane alone (RR: 0.51, 95% CI: 0.20-1.25, p = 0.140). Our findings showed that APCs, as well as collagen membrane plus bovine-derived hydroxyapatite, significantly improved wound healing after surgical endodontic therapy. In contrast, collagen membrane alone did not significantly improve wound healing outcomes. However, currently available studies vary significantly in sample size and methodologies. Hence, high-quality randomised controlled studies with large sample sizes are necessary to validate our findings.
一项荟萃分析评估了不同再生技术和材料对手术根管治疗后伤口愈合的影响，为手术根管治疗提供了参考。我们通过 PubMed、MEDLINE、EMBASE、Web of Science、中国知网（CNKI）和万方数据检索了关于手术根管治疗中使用再生技术和材料的研究，检索时间从数据库创建到 2022 年 12 月。两名研究人员独立筛选文献，根据纳入和排除标准提取信息，并评估纳入研究的质量。使用 Review Manager 5.4 进行荟萃分析。结果表明，使用再生技术和材料可显著降低伤口愈合失败率（风险比 [RR]：0.30，95%置信区间 [CI]：0.22-0.40，p<0.001）。此外，与单独使用胶原膜（RR：0.51，95%CI：0.20-1.25，p=0.140）相比，自体血小板浓度（RR：0.28，95%CI：0.15-0.53，p<0.001）和胶原膜加牛源性羟磷灰石（RR：0.27，95%CI：0.12-0.61，p=0.002）更有效地降低伤口愈合失败率。我们的研究结果表明，自体血小板浓度以及胶原膜加牛源性羟磷灰石可显著改善手术根管治疗后的伤口愈合。相比之下，单独使用胶原膜并不能显著改善伤口愈合效果。然而，目前的研究在样本量和方法学上存在显著差异。因此，需要开展高质量、大样本量的随机对照研究来验证我们的研究结果。
