Department of Stomatology, Liangxiang Hospital of Beijing Fangshan District, Beijing, China.
Acta Odontol Scand. 2024 Apr 22;83:166-173. doi: 10.2340/aos.v83.40255.
This study aims to compare the clinical efficacy of simple bone grafting and bone grafting combined with guided tissue regeneration (GTR) in periodontal regenerative therapy.
The authors systematically searched PubMed, the Web of Science, The National Library of Medicine, the China National Knowledge Infrastructure database and the Wanfang database and collected randomized controlled trials relating to bone graft co-guided tissue regeneration. The retrieval was conducted between January 1990 and December 2022. This study included relevant literature about the clinical efficacy of bone grafting combined with GTR according to the population, intervention, control and outcomes principle and excluded studies using other materials in addition to bone graft and membrane materials. After independently screening the literature, extracting the data and evaluating the risk of bias in the included studies, data analysis was performed using RevMan 5.3 software. Results: Eighteen studies met the inclusion criteria, and, after further evaluation, a total of 327 teeth that were featured in 15 articles were finally included for meta-analysis. The meta-analysis showed that there was no significant statistical difference in clinical attachment level, probing depth and bone gain between the test group (bone grafting with GTR) and the control group (bone grafting only) at 6 months after the operation (p > 0.05). In terms of gingival recession (GR), the use of non-resorbable membranes produced more recession in the test group compared with the control group (p < 0.05), whereas the use of resorbable membranes produced less recession (p < 0.05).
Both simple bone grafting and bone grafting combined with membrane materials have good clinical efficacy in periodontal regenerative therapy, and no significant difference in clinical efficacy is indicated between the two, with the exception of GR.
本研究旨在比较单纯骨移植与引导组织再生（GTR）联合骨移植在牙周再生治疗中的临床疗效。
作者系统检索了 PubMed、Web of Science、美国国立医学图书馆、中国知网和万方数据库，收集了与骨移植联合 GTR 引导组织再生相关的随机对照试验。检索时间为 1990 年 1 月至 2022 年 12 月。本研究根据人群、干预、对照和结局原则纳入了单纯骨移植联合 GTR 临床疗效的相关文献，并排除了除骨移植和膜材料外还使用其他材料的研究。在独立筛选文献、提取数据和评估纳入研究的偏倚风险后，使用 RevMan 5.3 软件进行数据分析。
纳入了 18 项研究，经过进一步评价，最终纳入了 15 篇文献中的 327 颗牙进行荟萃分析。荟萃分析结果显示，术后 6 个月时，试验组（GTR 联合骨移植）与对照组（单纯骨移植）的临床附着水平、探诊深度和骨增量差异均无统计学意义（p＞0.05）。在牙龈退缩（GR）方面，与对照组相比，使用不可吸收膜的试验组产生的 GR 更多（p＜0.05），而使用可吸收膜的试验组产生的 GR 较少（p＜0.05）。
单纯骨移植和膜材料联合骨移植在牙周再生治疗中均具有良好的临床疗效，除 GR 外，两种方法的临床疗效无显著差异。
