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用于上颌窦底提升的双相磷酸钙与脱蛋白牛骨矿物质:一项随机对照试验的系统评价和荟萃分析

Biphasic Calcium Phosphate Versus Deproteinized Bovine Bone Mineral for Sinus Floor Elevation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

作者信息

Alkandari Mohammed, Alkandari Meshari, Alhallaq Rashed, Mohammad Mohammad, Safar Daniah, Alobaidan Abdullah, Alobaidan Mubarak, Albusarah Sultan, Enki Awrad, Malallah Jumanah, Alenezi Abdulwahab T

机构信息

Department of Dentistry, Rumaithiya Polyclinic, Kuwait City, KWT.

Department of Dentistry, West Salmiya Polyclinic, Kuwait City, KWT.

出版信息

Cureus. 2025 Jul 9;17(7):e87573. doi: 10.7759/cureus.87573. eCollection 2025 Jul.


DOI:10.7759/cureus.87573
PMID:40641505
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12244758/
Abstract

Sinus floor elevation using deproteinized bovine bone mineral (DBBM) is widely used as a grafting material to promote new bone formation. Biphasic calcium phosphate (BCP) has also been utilized to enhance vertical and horizontal bone augmentation prior to dental implant placement. Both materials are considered viable options for sinus augmentation. This systematic review and meta-analysis aimed to evaluate the histological results of BCP compared to DBBM. A systematic search of PubMed, Scopus, Web of Science, and Cochrane Controlled Register of Trials (CENTRAL) was conducted from March 2025 to May 2025 to identify randomized controlled trials (RCTs) comparing BCP versus DBBM in patients undergoing sinus floor elevation. Primary outcomes included the percentage of new bone formation and residual bone graft. The secondary outcome was the percentage change in soft tissue. Pooled mean differences (MD) with 95% confidence intervals (CI) were calculated using a random-effects model. All analyses were performed using Stata/MP Version 18 (StataCorp LLC, College Station, Texas, United States). Ten RCTs involving 328 patients and 389 implants were included. BCP was associated with a higher percentage of new bone formation (MD=3.48; 95% CI: 0.89-5.97; p=0.01; I=44.03), lower residual grafting materials (MD=-8.41; 95% CI: -13.12 to -3.72; p<0.001; I=85.71), and higher soft tissue materials (MD=6.01; 95% CI: 2.39-9.63; p<0.001; I=71.96) compared to DBBM. In conclusion, the adjunctive use of BCP enhances histomorphometric outcomes in sinus floor elevation. Further high-quality, long-term RCTs with standardized protocols are needed to confirm these findings.

摘要

使用脱蛋白牛骨矿物质(DBBM)进行窦底提升术被广泛用作促进新骨形成的移植材料。双相磷酸钙(BCP)也已被用于在牙种植体植入前增强垂直和水平骨增量。这两种材料都被认为是窦底提升的可行选择。本系统评价和荟萃分析旨在评估与DBBM相比,BCP的组织学结果。于2025年3月至2025年5月对PubMed、Scopus、科学网和Cochrane对照试验注册库(CENTRAL)进行了系统检索,以确定比较BCP与DBBM用于接受窦底提升术患者的随机对照试验(RCT)。主要结局包括新骨形成百分比和剩余骨移植量。次要结局是软组织的百分比变化。采用随机效应模型计算合并平均差(MD)及95%置信区间(CI)。所有分析均使用Stata/MP 18版(美国德克萨斯州大学城的StataCorp有限责任公司)进行。纳入了10项涉及328例患者和389颗种植体的RCT。与DBBM相比,BCP与更高的新骨形成百分比(MD = 3.48;95% CI:0.89 - 5.97;p = 0.01;I² = 44.03)、更低的剩余移植材料(MD = - 8.41;95% CI: - 13.12至 - 3.72;p < 0.001;I² = 85.7)以及更高的软组织材料(MD = 6.01;95% CI:2.39 - 9.63;p < 0.001;I² = 71.96)相关。总之,辅助使用BCP可改善窦底提升术中的组织形态计量学结果。需要进一步开展具有标准化方案的高质量、长期RCT来证实这些发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/768f/12244758/4565eea70b36/cureus-0017-00000087573-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/768f/12244758/e14b9a743452/cureus-0017-00000087573-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/768f/12244758/db0763543467/cureus-0017-00000087573-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/768f/12244758/8adfc3c008b9/cureus-0017-00000087573-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/768f/12244758/64f65fb4ed6c/cureus-0017-00000087573-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/768f/12244758/0ae3a6cd9c8f/cureus-0017-00000087573-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/768f/12244758/e7ab11d7f86c/cureus-0017-00000087573-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/768f/12244758/4565eea70b36/cureus-0017-00000087573-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/768f/12244758/e14b9a743452/cureus-0017-00000087573-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/768f/12244758/db0763543467/cureus-0017-00000087573-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/768f/12244758/8adfc3c008b9/cureus-0017-00000087573-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/768f/12244758/64f65fb4ed6c/cureus-0017-00000087573-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/768f/12244758/0ae3a6cd9c8f/cureus-0017-00000087573-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/768f/12244758/e7ab11d7f86c/cureus-0017-00000087573-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/768f/12244758/4565eea70b36/cureus-0017-00000087573-i07.jpg

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本文引用的文献

[1]
Gene expression, micro-CT and histomorphometrical analysis of sinus floor augmentation with biphasic calcium phosphate and deproteinized bovine bone mineral: A randomized controlled clinical trial.

Clin Implant Dent Relat Res. 2024-4

[2]
Three-dimensional assessment after maxillary sinus grafting with a bovine, a porcine, and a synthetic bone substitute material. A randomized controlled clinical trial.

Int J Comput Dent. 2024-12-9

[3]
Sinus Floor Elevation with Biphasic Calcium Phosphate or Deproteinized Bovine Bone Mineral: Clinical and Histomorphometric Outcomes of a Randomized Controlled Clinical Trial.

Int J Oral Maxillofac Implants. 2020

[4]
RoB 2: a revised tool for assessing risk of bias in randomised trials.

BMJ. 2019-8-28

[5]
A Comparative Study with Biphasic Calcium Phosphate to Deproteinized Bovine Bone in Maxillary Sinus Augmentation: A Prospective Randomized and Controlled Clinical Trial.

Int J Oral Maxillofac Implants. 2019

[6]
Evaluation of bone substitutes for treatment of peri-implant bone defects: biomechanical, histological, and immunohistochemical analyses in the rabbit tibia.

J Periodontal Implant Sci. 2016-6

[7]
Histological outcomes of sinus augmentation for dental implants with calcium phosphate or deproteinized bovine bone: a systematic review and meta-analysis.

Int J Oral Maxillofac Surg. 2016-11

[8]
Sinus Floor Augmentation Using Straumann® BoneCeramic™ and Bio-Oss® in a Split Mouth Design and Later Placement of Implants: A 5-Year Report from a Longitudinal Study.

Clin Implant Dent Relat Res. 2016-10

[9]
Minimally invasive transcrestal sinus floor elevation with deproteinized bovine bone or β-tricalcium phosphate: a multicenter, double-blind, randomized, controlled clinical trial.

J Clin Periodontol. 2014-1-2

[10]
A histomorphometric and micro-computed tomography study of bone regeneration in the maxillary sinus comparing biphasic calcium phosphate and deproteinized cancellous bovine bone in a human split-mouth model.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2013-10-30

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