Salahi Sepehr, Shaar Mohamad Kamal, Pitman Jeremy, Vervaeke Stijn, Cosyn Jan, Younes Faris, De Bruyckere Thomas
Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences Oral Health Sciences, Ghent University, C. Heymanslaan 10, B-9000 Ghent, Belgium.
J Clin Med. 2025 Jul 28;14(15):5331. doi: 10.3390/jcm14155331.
: To compare the effect of different bone augmentation procedures, namely, autogenous bone blocks (ABBs) versus guided bone regeneration (GBR), on patient-reported outcomes (PROMs). : This systematic review was conducted according to the PRISMA guidelines. A MEDLINE, Embase, and Web of Science search was conducted by two independent reviewers in combination with a free-hand search in relevant journals until June 2025. Outcomes were PROMs to enhance our understanding of the evolution of these procedures. : The electronic search yielded 6291 articles. After title screening, 67 articles were further analyzed for abstract review, which resulted in 14 articles eligible for full-text reading. Six articles were finally included based on the exclusion and inclusion criteria with a total of 295 patients. The overall study quality was low, since only two RCTs could be included. One study demonstrated a high risk of bias. Different PROMs were examined and compared such as pain, edema, neurosensory disturbance, Patient-Reported Predominant Symptom, OHIP-14, postoperative analgesic usage, willingness to repeat, and likelihood to recommend. Meta-analysis was not achievable due to a lack of direct comparisons and heterogeneity in terms of PROMs. Evaluation points varied between pretreatment and up to nearly 10-years of follow-up. : Despite significant heterogeneity and reporting, this systematic review concluded that ABB and GBR are well-tolerated procedures. Trends such as transient postoperative pain and swelling with a minor occurring of neurosensory disturbances were reported in a few studies. Overall, a good perception of postoperative recovery was reported for both treatment modalities. Good quality of life was noted related to GBR procedures. Patient-reported outcomes were only analyzed for patients who completed the entire follow-up period. This may introduce bias, as patients who dropped out and were more likely to experience complications were not represented, potentially resulting in a more favorable portrayal of the outcomes. Further well-conducted prospective studies with a long follow-up are needed for an evidence-based evaluation and comparison of PROMs for these procedures.
为比较不同骨增量手术（即自体骨块[ABB]与引导骨再生[GBR]）对患者报告结局（PROMs）的影响。：本系统评价按照PRISMA指南进行。两名独立评价者对MEDLINE、Embase和Web of Science进行检索，并结合在相关期刊中的手工检索，直至2025年6月。结局指标为PROMs，以增进我们对这些手术演变的理解。：电子检索共获得6291篇文章。经过标题筛选，67篇文章进入摘要审查，最终14篇文章符合全文阅读要求。根据排除和纳入标准，最终纳入6篇文章，共295例患者。总体研究质量较低，因为仅纳入了两项随机对照试验。一项研究显示存在高偏倚风险。对不同的PROMs进行了检查和比较，如疼痛、水肿、神经感觉障碍、患者报告的主要症状、OHIP-14、术后镇痛药物使用情况、再次手术意愿和推荐可能性。由于缺乏直接比较以及PROMs方面的异质性，无法进行荟萃分析。评估时间点在术前至近10年的随访之间有所不同。：尽管存在显著的异质性和报告差异，但本系统评价得出结论，ABB和GBR手术耐受性良好。少数研究报告了术后短暂疼痛和肿胀以及轻微神经感觉障碍等趋势。总体而言，两种治疗方式的术后恢复情况均得到良好评价。与GBR手术相关的生活质量良好。仅对完成整个随访期的患者进行了患者报告结局分析。这可能会引入偏倚，因为未纳入退出研究且更可能出现并发症的患者，可能导致对结局的描述更为有利。需要进一步开展设计良好、随访时间长的前瞻性研究，以基于证据对这些手术的PROMs进行评估和比较。
