López-Valverde Nansi, López-Valverde Antonio, Blanco José Antonio
Department of Surgery, Faculty of Medicine, University of Salamanca, Salamanca, Spain.
Front Bioeng Biotechnol. 2025 Jun 25;13:1630495. doi: 10.3389/fbioe.2025.1630495. eCollection 2025.
The treatment of edentulism with dental implants is a common and reliable procedure with high medium- and long-term survival rates. Primary stability in the bone is vitally important to prevent micro-movements at the beginning of healing. However, the main drawback of dental implantology is bone deficiency. To alleviate this situation, clinicians' resort to surgical techniques that increase bone volume and allow the devices to be placed. Bone expansion, compaction, and densification are used to compact the bone trabeculae, densifying the bone and improving the primary stability and osseointegration of implants. The aim of the study was to evaluate the role of these surgical techniques in deficient alveolar ridges in order to prepare them to receive durable dental implants.
Searches were made of the PubMed/Medline, Embase, Cochrane Central, Dentistry and Oral Sciences Source and Web of Science (WOS) databases and GreyNet International, to identify RCTs, prospective studies, retrospective studies and case series published in English in the last 15 years, which evaluated the efficacy of bone expansion, bone compaction and densification in narrow alveolar ridges and their impact on bone density (BD), alveolar ridge expansion (CE) and implant stability quotient (ISQ). Methodological quality was evaluated using the Joanna Briggs Institute for RCTs (JBI MAStARI) tool and risk of bias using the Cochrane Risk of Bias Tool (RoB2), and meta-analyses were performed using Review Manager 5.4.1 software to calculate effect size and integrate the results of the included studies.
Ten of the 2,464 studies examined met the inclusion criteria. The meta-analysis of the parameters analyzed was favorable for the experimental group, indicating that bone expansion, compaction and densification techniques significantly increase DB (-0.71, 95% CI (Confidence Interval) [-1.15 to -0.27], p = 0.002), EC (-1.12, 95% CI [-2.21 to -0.03], p = 0.04) and ISQ (-8.88, 95% CI [-13.85 to -3.91], p = 0.0005), with a high publication bias for CE and ISQ.
The techniques of bone expansion, compaction and densification demonstrated their effectiveness in narrow alveolar ridges, although studies are needed to validate the results found.
Identifier CRD42025646738.
使用牙种植体治疗牙列缺失是一种常见且可靠的手术，具有较高的中长期生存率。骨内的初期稳定性对于在愈合初期防止微移动至关重要。然而，牙种植学的主要缺点是骨量不足。为缓解这种情况，临床医生采用增加骨量并允许植入装置放置的手术技术。骨扩张、压实和致密化用于压实骨小梁，使骨致密化并改善种植体的初期稳定性和骨整合。本研究的目的是评估这些手术技术在牙槽嵴缺损中的作用，以便为植入耐用牙种植体做好准备。
检索了PubMed/Medline、Embase、Cochrane Central、牙科学与口腔科学资源库以及科学网（WOS）数据库和GreyNet International，以识别过去15年以英文发表的随机对照试验、前瞻性研究、回顾性研究和病例系列，这些研究评估了骨扩张、骨压实和致密化在狭窄牙槽嵴中的疗效及其对骨密度（BD）、牙槽嵴扩张（CE）和种植体稳定性商数（ISQ）的影响。使用乔安娜·布里格斯循证卫生保健中心随机对照试验工具（JBI MAStARI）评估方法学质量，使用Cochrane偏倚风险工具（RoB2）评估偏倚风险，并使用Review Manager 5.4.1软件进行荟萃分析以计算效应量并整合纳入研究的结果。
在审查的2464项研究中，有10项符合纳入标准。对所分析参数的荟萃分析对实验组有利，表明骨扩张、压实和致密化技术显著增加了骨密度（-0.71，95%置信区间[CI][-1.15至-0.27]，p = 0.002）、牙槽嵴扩张（-1.12，95%CI[-2.21至-0.03]，p = 0.04）和种植体稳定性商数（-8.88，95%CI[-13.85至-3.91]，p = 0.0005），CE和ISQ存在较高的发表偏倚。
骨扩张、压实和致密化技术在狭窄牙槽嵴中显示出其有效性，尽管需要进行研究来验证所发现的结果。
标识符CRD42025646738。
