Int J Stomatol

Int J Stomatol ›› 2020, Vol. 47 ›› Issue (6): 644-651.doi: 10.7518/gjkq.2020110

• Original Articles • Previous Articles     Next Articles

Comparison of clinical outcomes between using bone graft alone and the combination of bone graft with membrane for periodontal regeneration therapy: a systematic review and Meta-analysis

Wang Shiqi1(),Chang Yaqin2,Chen Bin2,Tan Baochun2,Ni Yanhong1()   

  1. 1. Central Laboratory, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, China
    2. Dept. of Periodontology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, China
  • Received:2020-06-12 Revised:2020-08-02 Online:2020-11-01 Published:2020-11-06
  • Contact: Yanhong Ni E-mail:304484176@qq.com;niyanhong12@163.com
  • Supported by:
    Nanjing Health Excellent Youth Foundation(QRX17083)

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Abstract:

Objective This study aimed to compare the clinical effect of using bone graft alone with the combination of bone grafts and membrane in the periodontal regeneration therapy. Methods Relevant studies on the comparison of using bone graft alone and the combination of bone graft with membrane published from June 1988 to May 2019 were identified by electronic and manual search in PubMed, Cochrane, Embase, Web of Science, CNKI, CBM and Wanfang Databases. Using RevMan 5.3 software to make a statistical analysis of all the clinical outcomes. Results Twenty-two studies ful-filling the inclusion criteria were included in the analysis. After assessment, fifteen studies were selected for Meta-analysis and systematic review. Results showed at 6 months of post-surgery, there has no significant differences between bone grafts group and the combined group in terms of clinical attachment level, probing depth and vertical bone fill (P>0.05). For the gingival recession, the combined use of non-absorbable membrane lead to more recession (P<0.05) while the use of absorbable membrane lead to less recession (P<0.05). Conclusion Both the combined therapy and bone grafts alone are effective in the periodontal regeneration therapy, but the statistically differences between two methods were not observed in this limited study except for the gingival recession.

Key words: guided tissue regeneration, bone trans-plantation, periodontal regeneration, clinical effect, Meta-analysis

CLC Number: 

  • R782.1

TrendMD: 

Fig 1

Flow chart of literature screening"

Tab 1

Characteristics of included studies"

纳入研究 方法 例数 干预措施 随访/月 结局指标
类型 地区 试验组 对照组
Taheri等[8] 分口+平行 伊朗 8/10 Bio-Oss+Bio-Gide Bio-Oss 6 ①②③④
Kumar等[9] 分口设计 印度 27/27 Hydroxyapatite+AM Hydroxyapatite 6 ①②④
Chung等[10] 平行对照 韩国 10/10/10 BM+NC/BM+BC BM 3 ①②③④
Sali等[11] 分口设计 印度 10/10 DFDBA+AM DFDBA 12 ①②③④
Lyons等[12] 平行对照 美国 9/11 DFDBA+PLA DFDBA 9 ①②③④
Tsao等[13] 平行对照 美国 9/9 MBA+CM MBA 6 ①②④
Nygaard-Østby等[14] 平行对照 美国 19/20 AB+PLA AB 9 ①②③④
Keles等[15] 分口设计 土耳其 12/12 ACB+PLA ACB 6 ①②③④
Pajnigara等[16] 分口设计 印度 20/20 DFDBA+AM DFDBA 6 ①②③④
Kiliç等[17] 平行对照 土耳其 10/10 HAC+ePTFE HAC 6 ①②③④
Guillemin等[18] 分口设计 美国 15/15 DFDBA+ePTFE DFDBA 6 ①②③④
Reddy等[19] 分口设计 印度 10/10 Bio-Oss Collagen+Bio-Gide Bio-Oss Collagen 6 ①②③④
Khashu等[20] 分口设计 印度 6/6 PepGen P-15+Atrisorb PepGen P-15 9 ①②③④
Srivastava等[21] 平行对照 印度 16/14 Grabio Glascera+PerioCol™ GrabioGlascera™ 6 ①②④
Agarwal等[22] 平行对照 印度 8/8 DFDBA+PLA/PGA DFDBA 3、6 ①②④

Tab 2

Risk of bias of included studies"

纳入研究 随机方法 盲法 分配隐藏 结果的完整性 选择性报告 其他
Taheri等[8] 掷骰子 恰当 不清楚 无失访 恰当 恰当
Kumar等[9] 计算机 恰当 恰当 有失访（3/30） 恰当 恰当
Chung等[10] 计算机 恰当 恰当 无失访 恰当 恰当
Sali等[11] 计算机 恰当 恰当 无失访 恰当 恰当
Lyons等[12] 计算机 恰当 恰当 有失访（1/30） 恰当 恰当
Tsao等[13] 抽签 恰当 不清楚 有失访（3/30） 恰当 恰当
Nygaard-Østby等[14] 计算机 恰当 不清楚 有失访（1/40） 恰当 恰当
Keles等[15] 掷硬币 恰当 不清楚 无失访 恰当 恰当
Pajnigara等[16] 掷硬币 恰当 不清楚 无失访 不清楚 不清楚
Kiliç等[17] 不清楚 恰当 不清楚 无失访 不清楚 恰当
Guillemin等[18] 不清楚 不清楚 不清楚 无失访 恰当 不清楚
Reddy等[19] 掷硬币 不清楚 不清楚 无失访 恰当 不清楚
Khashu等[20] 不清楚 恰当 不清楚 无失访 不清楚 不清楚
Srivastava等[21] 掷硬币 不清楚 不清楚 无失访 不清楚 不清楚
Agarwal等[22] 不清楚 不清楚 不清楚 无失访 恰当 不清楚

Fig 2

Funnel plot of CAL changes 6 months after operation"

Tab 3

Results of sensitive analysis"

结局指标 纳入研究数 异质性检验结果 效应模型 Meta分析结果
P（组内） I2（组内） P（组间） I2（组间） MD（95%CI） P
CAL 6[8,13,15,19,21-22] 0.33 13% — — 固定 0.15（-0.04,0.34） 0.13
PD 5[8,13,15,19,21] 0.52 0% — — 固定 0.10（-0.28,0.48） 0.61
VBF 4[8,17-19] 0.36 6% — — 固定 0.84（0.42,1.26） <0.000 1
GR 4[8,15-16,19] 0.45 0% 0.27 22.6% 固定 -0.26（-0.46,-0.05） 0.01
GR 5[8,16-19] 0.01 69% 0.002 84.6% 随机 0.01（-0.40,0.42） 0.97
GR 5[8,15,17-19] 0.12 46% 0.03 72.5% 随机 0.08（-0.23,0.39） 0.61
GR 4[15,16,17,18] 0.005 77% 0.002 84.3% 随机 0.07（-0.43,0.58） 0.77
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