摘要
目的:目前临床上关于上颌窦提升的同时是否使用植骨材料的观点尚未达成共识,仍存在争议。为此,文章对穿牙槽嵴顶上颌窦底提升术并同期植入种植体,使用和不使用骨移植材料的临床疗效进行对比分析。方法:通过计算机检索中国知网、万方、维普、CBM、EMbase、PubMed、Web of Science和Cochrane图书馆数据库中所有公开发表的国内外有关穿牙槽嵴顶上颌窦提升术后与使用骨移植材料有关的临床研究。最终由2位评价员按照Cochrane手册和NOS量表进行文献质量评价后,应用RevMan 5.3软件及Stata 15.1软件对最终符合纳入标准的研究数据进行Meta分析。结果:①最终共纳入11篇文献,有6篇为随机对照试验,剩余5篇为前瞻性队列研究,共包括994枚种植体,其中植骨组399枚,不植骨组595枚;②Meta分析结果显示:上颌窦内提升术同期植入种植体使用与不使用骨移植材料两者的术后种植体失败率(RR=0.57,95%CI:0.28-1.18,P=0.13)及种植体周围骨吸收量(SMD=0.03,95%CI:-0.23-0.29,P=0.80)差异均无显著性意义;不植骨组黏膜穿孔风险要低于植骨组(RR=0.33,95%CI:0.12-0.96,P=0.04);但是不植骨组日后上颌窦内新骨形成量明显低于植骨组(SMD=-0.89,95%CI:-1.08至-0.70,P<0.05)。结论:上颌窦内提升同期植入种植体植骨与不植骨均可以获得可预期效果,两组在种植体失败率、种植体周围骨吸收量方面两组无显著差异,植骨组可以获得更多的新骨量,但是植骨组黏膜穿孔率高于不植骨组。因此临床中选择上颌窦内提升同期植入种植体不使用骨移植材料具有更多优点,且安全性较高。但由于文章纳入的研究质量限制,尚有许多不足之处,期待未来能有更多具有高质量水平的随机对照试验,在多中心、大样本的分析下得出更可靠的结论。
OBJECTIVE:At present,there is no consensus on whether to use bone grafts while lifting the macillary sinus,and there are still controversies.This article compared and analyzed the clinical outcome after transalveolar sinus floor elevation with or without grafting materials.METHODS:A computer search was conducted to search all clinical studies on transalveolar sinus floor elevation with and without grafting materials published in CNKI,Wanfang,VIP,CBM,Embase,PubMed,Web of Science and Cochrane.Finally,two reviewers independently extracted study data and conducted quality assessments according to the Cochrane manual and NOS scale,and then used RevMan 5.3 software and Stata 15.1 software to analyze the research data which finally met the inclusion criteria for meta-analysis.RESULTS:(1)A total of eleven articles were included,six were randomized controlled trials and five were prospective cohort studies,including 994 implants,with 399 implants in the graft group and 595 implants in the non-graft group.(2)The results of meta-analysis showed that there was no significant difference in implant failure rate(RR=0.57,95%CI:0.28-1.18,P=0.13),and marginal bone loss(SMD=0.03,95%CI:-0.23-0.29,P=0.80)between implants with and without graft materials after transalveolar sinus floor elevation.The risk of membrane perforation in the non-graft group was lower than that in the graft group(RR=0.33,95%CI:0.12-0.96,P=0.04),but the amount of endo-sinus bone gain in the non-graft group was significantly lower than that in the graft group(SMD=-0.89,95%CI:-1.08 to-0.70,P<0.05).CONCLUSION:Transalveolar sinus floor elevation simultaneously implanted with grafting and without grafting can achieve predictable results.There were no statistically significant difference between two groups in implant failure rate and marginal bone loss.There may be a trend toward more endo-sinus bone gain with grafting.However,the sinus membrane perforation rate in the graft group was higher than that in the non-graft group.Therefore,choosing transalveolar sinus flo
作者
石前会
伍超
周倩
齐昱晗
霍花
廖健
Shi Qianhui;Wu Chao;Zhou Qian;Qi Yuhan;Huo Hua;Liao Jian(School/Hospital of Stomatology of Guizhou Medical University,Guiyang 550004,Guizhou Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2021年第34期5570-5576,共7页
Chinese Journal of Tissue Engineering Research
基金
贵州省自然科学基金联合基金项目(黔科合LH[2016]7257),项目负责人:廖健。
关键词
骨
上颌窦
骨增量
骨移植材料
上颌窦提升手术
口腔种植体
META分析
bone
maxillary sinus
bone augmentation
bone graft material
maxillary sinus elevation
oral implants
meta-analysis
