Meta-analysis of application of autogenous dentin for alveolar ridge augmentation

doi:10.7518/hxkq.2022.05.010

Abstract

Abstract:

Objective This investigation aimed to systematically evaluate the efficacy and safety of applying autogenous dentin (ATD) in alveolar ridge augmentation. Methods The PubMed, Embase, Web of Science, Cochrane Library, CNKI, and Wanfang databases were electronically searched from January 1, 2010 to March 19, 2022 to identify clinical trials and cohort studies that employed ATD in alveolar ridge augmentation. The Cochrane Tool and the Newcastle-Ottawa Scale were employed to assess the risk of bias in randomized controlled trials and cohort studies, respectively. Data were analyzed via RevMan 5.4 software. Results A total of 10 studies were included, 5 of which compared ATD with autologous bone and 5 with deproteinized bovine bone matrix (DBBM). Meta-analysis indicated that ATD had preferable performance [MD=2.01, 95% confidence interval (CI) (1.09, 2.93), P<0.000 1] in horizontal ridge augmentation compared with autologous bone but similar effect in vertical ridge augmentation [MD=-0.06, 95%CI (-0.21, 0.08), P=0.39] at 6 months after alveolar ridge augmentation. In terms of material absorption, ATD was significantly less than autologous bone or DBBM [MD=-0.59, 95%CI (-1.03, -0.15), P=0.008; MD=-0.63, 95%CI (-1.18, -0.07), P=0.03], but no significant difference in implant stability quotient and postoperative complications was observed [MD=-0.76, 95%CI (-3.04, 1.52), P=0.51; RR=1.01, 95%CI (0.33, 3.12), P=0.98]. Conclusion ATD, as a bone grafted material for alveolar ridge augmentation, not only achieves similar or better bone incremental performance than autologous bone or DBBM but also has less absorption. However, further evidence from clinical trials with larger samples, higher quality, and longer follow-up period are needed to evaluate its superiority.

Key words: dentin, autologous bone, alveolar ridge augmentation, bone graft, dental implant, Meta-analysis

CLC Number:

R 783.1

Gong Jiaming, Zhang Qihang, Gou Ping, Wang Hui, Yu Jiaying, Yu Zhanhai. Meta-analysis of application of autogenous dentin for alveolar ridge augmentation[J]. West China Journal of Stomatology, 2022, 40(5): 566-575.

Figures/Tables 7

Tab 1

Characteristics of included study

作者/年份	研究设计	患者/种植体	移植骨来源	手术程序	随访时间	结局指标
涉及水平向牙槽嵴骨增量
Korsch 2021^[21]	CS	28/38	松动牙或第三磨牙	自体牙预备成1~1.5 mm牙本质壳后骨钉固定，间隙内覆盖ATD颗粒，同期植入种植体	5月	⑤⑥
				自体牙预备成1~1.5 mm牙本质壳后骨钉固定，间隙内覆盖ATD颗粒，同期植入种植体
		31/41	下颌磨牙后区/外斜线	自体骨预备成骨块后骨钉固定，间隙内充填自体骨颗粒，同期植入种植体
			下颌磨牙后区/外斜线	自体骨预备成骨块后骨钉固定，间隙内充填自体骨颗粒，同期植入种植体
Schwarz 2018^[23]	CS	15/15	第三磨牙	自体牙预备成牙本质块后骨钉固定，术后26周植入种植体	26周	①②⑥
		15/15	磨牙后区	自体骨预备成骨块后骨钉固定，术后26周植入种植体
Schwarz 2019^[24]	CS*	13/13	第三磨牙	自体牙预备成牙本质块后骨钉固定，术后26周植入种植体	26周	①⑥
		10/10	磨牙后区	自体骨预备成骨块后骨钉固定，术后26周植入种植体	26周
潘凌峰 2020^[30]	RCT	42/-	第三磨牙	ATD粉碎成0.5~1 mm颗粒后脱矿并混合PRP后充填，覆盖Bio-Gide，同期植入种植体	12月	①⑥
				ATD粉碎成0.5~1 mm颗粒后脱矿并混合PRP后充填，覆盖Bio-Gide，同期植入种植体
		42/-	异种骨	Bio-Oss充填，覆盖Bio-Gide，同期植入种植体
林继超 2019^[26]	CS	5/11	松动牙或阻生齿	ATD粉碎成<1 mm颗粒后脱矿充填，同期植入种植体	（11.86±1.96）月	②⑥
		5/10	异种骨	Bio-Oss充填，同期植入种植体
涉及垂直向牙槽嵴骨增量
Pang 2017^[28]	RCT	15/21	无法保留牙齿	ATD粉碎成300~800 μm颗粒后脱矿充填，术后6个月植入种植体	6月	③⑤⑥
				ATD粉碎成300~800 μm颗粒后脱矿充填，术后6个月植入种植体
		12/12	异种骨	Bio-Oss充填，术后6个月植入种植体
Li 2018^[27]	RCT	19/23	松动牙	ATD粉碎成0.5~1 mm颗粒后脱矿并混合PRF充填，覆盖Bio-Gide，同期植入种植体	18月	⑤⑥
				ATD粉碎成0.5~1 mm颗粒后脱矿并混合PRF充填，覆盖Bio-Gide，同期植入种植体
		19/22	异种骨	Bio-Oss混合PRF充填，覆盖Bio-Gide，同期植入种植体
孙娟斌 2016^[29]	RCT	21/-	松动牙或阻生齿	ATD粉碎成300~1 200 μm颗粒后脱矿充填，覆盖Bio-Gide	12月	③⑥
		21/-	异种骨	Bio-Oss充填，覆盖Bio-Gide
涉及水平和垂直向牙槽嵴骨增量
Schwarz 2022^[25]	CS	14/15	第三磨牙	自体牙预备成牙本质块后骨钉固定，术后26周植入种植体	26周	②③④⑥
		14/17	外斜线	自体骨预备成骨块后骨钉固定，术后26周植入种植体
Xiao 2019^[22]	CS	7/10	第三磨牙	自体牙预备成<2 mm牙本质壳后骨钉固定，间隙内充填Bio-Oss和1 mm CGF膜，覆盖Bio-Gide，术后6个月植入种植体	6月	②③④⑥

		6/11	外斜线	自体骨预备成<2 mm骨壳后骨钉固定，间隙内充填Bio-Oss和1 mm CGF膜，覆盖Bio-Gide，术后6个月植入种植体

Tab 1

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Fig 4

Fig 5

Fig 6

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