Centre for Education and Research on Dental Implants (CEPID), Department of Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, Brazil.
Department of Surgery and Medical-Surgical Specialties (Dentistry - Unit of Periodontology), Faculty of Medicine and Odontology, University of Santiago de Compostela, Santiago de Compostela, Spain.
Clin Implant Dent Relat Res. 2024 Feb;26(1):4-14. doi: 10.1111/cid.13257. Epub 2023 Sep 6.
The present systematic review aimed to identify and summarize the clinical, radiographic, and histological outcomes of alveolar ridge preservation using bone xenografts and absorbable sealing materials compared with spontaneous healing in the esthetic zone.
Randomized clinical trials (RCTs) fulfilling specific eligibility criteria were included. Two review authors independently searched for eligible studies, extracted data from the published reports and performed the risk of bias assessment (RoB 2 tool). Study results were summarized using random effects meta-analyses.
Thirteen articles concerning 10 RCTs were included, involving a total of 357 participants. Most of studies were considered as "low" risk of bias. Meta-analyses indicated less horizontal (difference in means-MD = 1.88 mm; p < 0.001), vertical mid-buccal (MD = 1.84 mm; p < 0.001) and vertical mid-lingual (MD = 2.27 mm; p < 0.001) bone resorption in alveolar ridge preservation compared to spontaneous healing as assessed clinically. Bone changes assessed radiographically showed consistent results in terms of horizontal (at 1 mm: MD = 1.84 mm, p < 0.001), vertical mid-buccal (MD = 0.95 mm; p < 0.001) and mid-lingual (MD = 0.62 mm; p = 0.05) resorption. Part of the bone resorption in the spontaneous healing group was compensated by soft-tissues, since the observed differences between groups in linear ridge reduction evaluated through cast models superimposition were smaller (MD = 0.52 mm; p < 0.001).
Alveolar ridge preservation with xenogeneic bone substitutes and non-autogenous resorbable socket sealing materials is efficacious in reducing post-extraction bone and ridge changes in the esthetic region.
本系统评价旨在确定并总结使用异种骨移植物和可吸收密封材料进行牙槽嵴保存的临床、放射影像学和组织学结果，与美学区的自发愈合相比。
纳入符合特定纳入标准的随机临床试验（RCT）。两名综述作者独立搜索符合条件的研究，从已发表的报告中提取数据，并进行偏倚风险评估（RoB 2 工具）。使用随机效应荟萃分析总结研究结果。
纳入了 13 篇关于 10 项 RCT 的文章，共涉及 357 名参与者。大多数研究被认为是“低”偏倚风险。荟萃分析表明，与自发愈合相比，牙槽嵴保存的水平（均数差-MD=1.88mm；p<0.001）、颊侧中（MD=1.84mm；p<0.001）和舌侧中（MD=2.27mm；p<0.001）骨吸收减少。影像学评估的骨变化在水平方向上（在 1mm 处：MD=1.84mm，p<0.001）、颊侧中（MD=0.95mm；p<0.001）和舌侧中（MD=0.62mm；p=0.05）具有一致的结果，显示出一致的结果。自发愈合组中部分骨吸收被软组织补偿，因为通过模型叠加评估的线性牙槽嵴减少，观察到组间差异较小（MD=0.52mm；p<0.001）。
在美学区，使用异种骨替代物和非自体可吸收封闭材料进行牙槽嵴保存可以有效减少拔牙后骨和牙槽嵴的变化。
