Sun Xiaolan, Yang Yongtao, Yin Wei, Li Limei, Yuan Qin, Qin Xianan
Department of Stomatology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, Guangdong 518033, P.R. China.
Department of Oral and Maxillofacial Surgery, Shenzhen Stomatology Hospital Affiliated to Shenzhen University, Shenzhen, Guangdong 518022, P.R. China.
Biomed Rep. 2025 May 14;23(1):117. doi: 10.3892/br.2025.1995. eCollection 2025 Jul.
Alveolar bone loss after tooth extraction can complicate subsequent implant placement and compromise aesthetic outcomes. High-concentration growth factors, including plasma rich in growth factors (PRGF) and concentrated growth factors (CGF), have been explored as potential interventions to enhance bone preservation and improve clinical outcomes. A systematic review and meta-analysis were conducted to include the studies no later than November 2024. A total of eight studies with a combined sample size of 393 participants met the inclusion criteria. Quality was assessed using the Jadad Scale, and publication bias was evaluated through Begg's test, Egger's test, and Duval and Tweedie's trim-and-fill method. Pooled effect sizes for alveolar bone preservation were calculated using fixed-effects and random-effects models, with additional sensitivity, cumulative, and precision interval analyses to confirm the robustness of the findings. The pooled analysis showed a significant positive effect of high-concentration growth factors on alveolar bone preservation. The fixed-effects model yielded a standardized mean difference of 0.614 (95% CI, 0.4122-0.815), while the random-effects model produced a standardized mean difference of 0.593 (95% CI, 0.244-0.942), both indicating enhanced bone volume and width retention with growth factor application. Cumulative analysis demonstrated consistency of effect sizes over time, while sensitivity analysis confirmed stability, showing no undue influence by any single study. Publication bias assessments showed minimal risk, with Begg's and Egger's tests non-significant and the trim-and-fill method showing no adjustment needed. High-concentration growth factors, such as PRGF and CGF, show promise as minimally invasive approaches for enhancing alveolar bone preservation after tooth extraction. These findings support their use in clinical practice for improved surgical outcomes. Future studies should focus on protocol standardization, long-term impact on implant stability, and patient-centered outcomes.
拔牙后牙槽骨吸收会使后续种植体植入复杂化，并影响美学效果。高浓度生长因子，包括富含生长因子的血浆（PRGF）和浓缩生长因子（CGF），已被探索作为增强骨保留和改善临床效果的潜在干预措施。进行了一项系统评价和荟萃分析，纳入截至2024年11月的研究。共有八项研究符合纳入标准，合并样本量为393名参与者。使用Jadad量表评估质量，并通过Begg检验、Egger检验和Duval及Tweedie的修剪填充法评估发表偏倚。使用固定效应和随机效应模型计算牙槽骨保留的合并效应量，并进行额外的敏感性、累积性和精确区间分析以确认结果的稳健性。汇总分析显示高浓度生长因子对牙槽骨保留有显著的积极作用。固定效应模型得出的标准化平均差为0.614（95%CI，0.4122 - 0.815），而随机效应模型得出的标准化平均差为0.593（95%CI，0.244 - 0.942），两者均表明应用生长因子可增强骨体积和宽度的保留。累积分析表明效应量随时间的一致性，而敏感性分析证实了稳定性，表明没有任何单个研究产生不当影响。发表偏倚评估显示风险极小，Begg检验和Egger检验均无显著性差异，修剪填充法显示无需调整。PRGF和CGF等高浓度生长因子有望作为拔牙后增强牙槽骨保留的微创方法。这些发现支持其在临床实践中的应用以改善手术效果。未来的研究应专注于方案标准化、对种植体稳定性的长期影响以及以患者为中心的结果。
