Sinus Floor Augmentation Surgery Using Autologous Bone Grafts from Various Donor Sites: A Meta-Analysis of the Total Bone Volume
Sinus Floor Augmentation Surgery Using Autologous Bone Grafts from Various Donor Sites: A Meta-Analysis of the Total Bone Volume
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DOI：
10.1089/ten.teb.2009.0558
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发表时间：
2010-06-01
影响因子：
6.4
通讯作者：
Jansen, John A.
中科院分区：
文献类型：
--
作者：
Klijn, Reinoud J.;Meijer, Gert J.;Jansen, John A.
背景：迄今为止，还没有发表的研究评估大量患者的组织形态学数据，同时比较不同部位和方法的自体骨移植在窦底增强手术中的应用。对1995年1月至2009年4月的英文文献进行meta分析。材料与方法：检索PubMed搜索引擎和以下期刊：《临床口腔种植研究》、《国际口腔颌面种植杂志》、《国际牙周病与修复牙科杂志》和《牙周病学杂志》。结果：147篇文章中，根据我们的标准，有25篇文章被留作分析。大多数是前瞻性对照研究（21项），2项随机临床试验，1项先导研究和1例病例系列。以髂骨植骨为标准，总骨体积（TBV）参考值为47%。使用口内骨移植增加TBV，下颌骨增加11%，其他口内骨增加14%。骨移植颗粒对TBV有18%的负面影响。令人惊讶的是，TBV与移植物愈合时间没有相关性。组织学切片厚度似乎是一个显著的变量，切片厚度每增加一个微米，导致TBV增加0.4%。结论：与口内植骨相比，髂骨植骨可显著降低TBV。然而，由于可获得的口内骨有限，髂移植物仍然被认为是增加严重萎缩的上颌骨的金标准。
Background: To date, no studies have been published that evaluated histomorphometric data from a large number of patients while comparing different sites and methods of autologous bone grafting in sinus floor augmentation procedures. A meta-analysis of the English literature from January 1995 till April 2009 was carried out.Materials and Methods: PubMed search engine and the following journals were explored: Clinical Oral Implant Research, International Journal of Oral and Maxillofacial Implants, International Journal of Periodontics and Restorative Dentistry, and the Journal of Periodontology.Results: Out of 147 titles, according to our criteria, 25 articles were left for analysis. The majority were prospective controlled studies (21) and 2 randomized clinical trials, 1 pilot study and 1 case series. A reference value of 47% for total bone volume (TBV) was found while using iliac bone grafting as a standard. Use of intraoral bone grafts increases the TBV, with 11% for chin bone and 14% for bone grafted from other intraoral sites. Particulation of the bone graft has a negative effect on the TBV of 18%. Surprisingly, no correlation between TBV and the time of graft healing was found. Histological section thickness seemed to be a significant variable, as every micron increase of section thickness leads to an increase of 0.4% of TBV.Conclusions: Bone grafting from the iliac crest resulted in a significantly lower TBV compared with intraoral bone grafting. However, due to the limited availability of intraoral bone to be harvested, iliac grafts still have to be considered the gold standard in augmenting the severely atrophic maxilla.