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关于自体血小板浓缩物在牙槽骨增量术中应用的叙述性综述:水平(同期/分期)及垂直(同期/分期)。

A narrative review on the use of autologous platelet concentrates during alveolar bone augmentation: Horizontal (simultaneous/staged) & vertical (simultaneous/staged).

作者信息

Blanco J, Caramês J, Quirynen M

机构信息

Department of Surgery and Medical-Surgical Specialties (Area of Stomatology. Unit of Periodontology), Faculty of Medicine and Odontology, University of Santiago de Compostela, Santiago de Compostela, Spain.

Department of Oral Surgery and Implantology, Unit of Oral Surgery, Faculty of Dental Medicine, University of Lisbon, Lisbon, Portugal.

出版信息

Periodontol 2000. 2025 Feb;97(1):236-253. doi: 10.1111/prd.12604. Epub 2024 Aug 28.

Abstract

This review aimed to answer the general question of whether autologous platelet concentrates (APCs, an autologous blood-derivative) can improve the outcome of alveolar bone augmentation. Three clinical scenarios were assessed: horizontal/vertical bone augmentation in combination with implant placement (simultaneous approach), horizontal bone augmentation in a staged approach, and vertical bone augmentation in a staged approach. An electronic literature search strategy was conducted for each review from the outset to July 1st, 2023. The titles and abstracts (when available) of all identified studies were screened and imported into a database. If articles appeared to meet the inclusion criteria or their title and abstract had insufficient data, the full text was obtained to make the final decision. All studies that met the inclusion criteria underwent data extraction. Moreover, the references of the identified papers were screened for additional studies. After title and abstract screening and selection criteria application, 14 clinical studies were included for the qualitative analysis: seven for horizontal/vertical bone augmentation in a simultaneous approach, five for horizontal bone augmentation in a staged approach, and two for vertical bone augmentation in a staged approach. There is scarce literature regarding the added value of APCs in bone augmentation, and most studies had small sample sizes, a lack of standardized protocols, and different outcome variables, which makes comparisons between studies difficult. Out of the 14 studies, four were well-designed randomized clinical trials, where we could find better results for the APCs groups. Most studies, particularly comparative and well-designed studies, demonstrated beneficial and promising results of using APCs in alveolar bone augmentation. However, before high-level evidence-based conclusions can be drawn, more randomized clinical trials must compare the benefits of adding APCs to the gold-standard approach.

摘要

本综述旨在回答自体血小板浓缩物(APCs,一种自体血液衍生物)是否能改善牙槽骨增量效果这一总体问题。评估了三种临床情况:水平/垂直骨增量联合种植体植入(同期方法)、分期进行的水平骨增量以及分期进行的垂直骨增量。从一开始到2023年7月1日,针对每项综述都实施了电子文献检索策略。对所有已确定研究的标题和摘要(如有)进行筛选,并导入数据库。如果文章似乎符合纳入标准,或者其标题和摘要数据不足,则获取全文以做出最终决定。所有符合纳入标准的研究都进行了数据提取。此外,对已确定论文的参考文献进行筛选以查找其他研究。经过标题和摘要筛选以及应用选择标准后,纳入了14项临床研究进行定性分析:7项关于同期水平/垂直骨增量,5项关于分期水平骨增量,2项关于分期垂直骨增量。关于APCs在骨增量中的附加价值的文献很少,并且大多数研究样本量小、缺乏标准化方案且结果变量不同,这使得研究之间难以进行比较。在这14项研究中,有4项是设计良好的随机临床试验,我们在其中可以发现APCs组有更好的结果。大多数研究,特别是比较性和设计良好的研究,都证明了在牙槽骨增量中使用APCs有有益且有前景的结果。然而,在得出基于高级别证据的结论之前,必须有更多的随机临床试验来比较在金标准方法中添加APCs的益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dca5/11808422/f38d91a2d76d/PRD-97-236-g003.jpg

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