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唇腭裂患者使用骨替代物进行牙槽骨植骨的荟萃分析。

A meta-analysis of alveolar bone grafting using bone substitutes in cleft lip and palate patients.

作者信息

Putri Indri Lakhsmi, Fabian Pascalis, Wungu Citrawati Dyah Kencono

机构信息

Department of Plastic Reconstructive and Aesthetic Surgery, Faculty of Medicine, Airlangga University, Surabaya, Indonesia.

Plastic Reconstructive and Aesthetic Surgery Unit, Airlangga Universitas Hospital, Surabaya, Indonesia.

出版信息

Tzu Chi Med J. 2024 Jan 12;36(1):53-58. doi: 10.4103/tcmj.tcmj_125_23. eCollection 2024 Jan-Mar.

Abstract

In individuals with cleft lip and palate (CLP), an alveolar bone graft (ABG) is carried out for alveolar cleft closure. Several sources for ABG include autologous bone, xenologous bone, and alloplastic substitutes. Autologous bone has been the preferred source for ABG. Alloplastic substitutes might serve as an alternative. This study aimed to compare the outcomes between autologous and alloplastic as sources for ABG. This study made use of eight web databases. Randomized control trial (RCTs) and non-RCTs were included. CLP patients with alveolar cleft with imaging studies, computed tomography (CT scan) and/or cone beam CT scan, and bone graft volume within 6-12 months postintervention were selected. Bone graft volume within 6-12 months postintervention was assessed. Three studies met the inclusion criteria. After 6-12 months of follow-up, there were no statistically significant differences in bone graft volume between autologous and alloplastic bone grafts (fixed-effect model estimate value = 0.21; confidence interval - 0.301-0.730; = 0.414). The limitations include small research sample sizes, a high likelihood of bias among included studies, and different alloplastic materials from each included study. Autologous and alloplastic bone grafts showed similar effectiveness in alveolar bone grafting. Further clinical trial studies with bigger sample sizes and similar interventions are needed as evidence for future reviews.

摘要

对于唇腭裂(CLP)患者,需进行牙槽骨移植(ABG)以关闭牙槽裂。ABG的来源有多种,包括自体骨、异种骨和异体替代物。自体骨一直是ABG的首选来源。异体替代物可作为一种替代选择。本研究旨在比较自体骨和异体替代物作为ABG来源的效果。本研究使用了八个网络数据库。纳入了随机对照试验(RCT)和非RCT。选择有牙槽裂的CLP患者,并进行影像学检查,即计算机断层扫描(CT扫描)和/或锥形束CT扫描,同时记录干预后6至12个月内的骨移植体积。评估干预后6至12个月内的骨移植体积。三项研究符合纳入标准。经过6至12个月的随访,自体骨移植和异体骨移植在骨移植体积方面无统计学显著差异(固定效应模型估计值 = 0.21;置信区间 - 0.301 - 0.730;P = 0.414)。局限性包括研究样本量小、纳入研究存在偏倚的可能性高以及各纳入研究使用的异体材料不同。自体骨移植和异体骨移植在牙槽骨移植中显示出相似的效果。需要进一步开展样本量更大且干预措施相似的临床试验研究,为未来的综述提供证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0116/10887340/c3d83e189b21/TCMJ-36-53-g001.jpg

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