Gasparro Roberta, Di Lauro Alessandro Espedito, Campana Maria Domenica, Rosiello Nicola, Mariniello Mauro, Sammartino Gilberto, Marenzi Gaetano
Department of Neurosciences, Reproductive Sciences and Oral Sciences, Section of Oral Surgery, University of Naples Federico II, 80131 Naples, Italy.
Dent J (Basel). 2024 Apr 10;12(4):101. doi: 10.3390/dj12040101.
Maxillary sinus augmentation is one of the most predictable procedures for the rehabilitation of the posterior maxilla. The current overview aimed to summarize the findings provided by systematic reviews (SRs) and meta-analyses on the effectiveness of autologous platelet concentrates (APCs) in sinus lift and to assess the methodological quality of the included SRs. Three electronic databases have been explored. SRs and meta-analyses addressing the effectiveness of APCs in sinus lift technique were included. Clinical, radiographic and histomorphometric findings were considered for APCs as solely grafting materials and APCs in combination with biomaterials. Outcomes were implant survival rate (ISR), implant stability (IS), implant failure (IF), postoperative complications, histomorphometric findings, radiographic bone gain, bone volume and bone density. The methodological quality of the included SRs was assessed using the updated version of "A Measurement Tool to Assess Systematic Review" (AMSTAR-2). Thirty SRs were included. The methodological quality of the included reviews ranged from critically low (3 studies) to high (9 studies). The included SRs showed favorable clinical outcomes, short-term new bone formation and no biological complications when APCs were used both as solely graft material or in combination with other biomaterials. However, no significant additional effects in the long-term period were observed. APCs did not add any further positive effects compared to the physiological healing derived by the natural blood clot. The current overview of SRs highlighted the need for high-quality SRs evaluating the role of APCs in sinus lift though network meta-analyses, in order to identify the most powerful material for sinus lift augmentation. The use of APCs improves the healing of soft tissues and the postoperative quality of life in the short-term period. Thus, its application can be recommended.
上颌窦提升术是上颌后牙区骨量不足时最具可预测性的修复手术之一。本综述旨在总结系统评价(SR)和荟萃分析中关于自体血小板浓缩物(APC)在窦底提升术中有效性的研究结果,并评估纳入的SR的方法学质量。我们检索了三个电子数据库。纳入了探讨APC在窦底提升术有效性的SR和荟萃分析。将APC单独作为移植材料以及与生物材料联合使用时的临床、影像学和组织形态计量学结果纳入分析。结局指标包括种植体存活率(ISR)、种植体稳定性(IS)、种植体失败(IF)、术后并发症、组织形态计量学结果、影像学骨增量、骨体积和骨密度。使用更新版的“系统评价评估测量工具”(AMSTAR-2)评估纳入SR的方法学质量。共纳入30篇SR。纳入综述的方法学质量从极低(3项研究)到高(9项研究)不等。纳入的SR显示,当APC单独作为移植材料或与其他生物材料联合使用时,具有良好的临床结局、短期新骨形成且无生物学并发症。然而,长期未观察到显著的额外效果。与自然血凝块产生的生理性愈合相比,APC没有增加任何进一步的积极作用。目前对SR的综述强调,需要通过网络荟萃分析进行高质量的SR,以评估APC在窦底提升术中的作用,从而确定用于窦底提升增强的最有效材料。APC的使用在短期内改善了软组织愈合和术后生活质量。因此,推荐其应用。