脱钙异体冻干骨联合富血小板衍生物治疗牙周骨内缺损疗效的Meta分析

目的 系统评价脱钙异体冻干骨（DFDBA）联合富血小板衍生物治疗牙周病导致的骨内缺损的有效性。方法 在PubMed、Web of Science、Embase、Cochrane Library、中国学术期刊网全文数据库等数据库中检索2016年5月之前发表的关于DFDBA联合富血小板衍生物治疗牙周病导致的骨内缺损的临床随机对照研究（RCT）。对纳入的文献研究进行质量评价。应用RevMan 5.3软件进行Meta分析。结果 9篇RCT文献纳入Meta分析,共194例患者,303个位点。Meta分析结果显示:DFDBA联合富血小板衍生物试验组较对照组可以降低短期组（6个月）和长期组（12~18个月）的牙周袋探诊深度,均数差（MD）分别为0.75 mm95%可信区间（CI）（0.31 mm,1.20 mm）,P=0.001 0]、0.87 mm95%CI（0.02 mm,1.72 mm）,P=0.04];增加短期组（6个月）和长期组（12~18个月）的临床附着水平,MD分别为0.65 mm95%CI（0.08 mm,1.22 mm）,P=0.03]、1.31 mm95%CI（0.60 mm,2.01 mm）,P=0.000 3];减少长期组（12~18个月）的牙龈退缩MD为-0.58 mm,95%CI（-0.78 mm,-0.38 mm）,P<0.000 01];增加短期组（6个月）和长期组（12~18个月）的骨充填高度,MD分别为0.52 mm95%CI（0.03 mm,1.00 mm）,P=0.04]、1.26 mm95%CI（0.65 mm,1.86 mm）,P=0.000 1]。结论 DFDBA联合富血小板衍生物能有效治疗牙周病导致的骨内缺损,效果优于单用组。但因为此次纳入研究较少,质量不高且样本量较小,所以仍需高质量的、大样本的RCT来进一步验证。

Decalcified freeze-dried bone allograft combined with rich platelet derivatives for the treatment of human periodontal intrabony defects: a Meta-analysis

Objective This review aims to systematically evaluate the effect of decalcified freeze-dried bone allograft (DFDBA) combined with rich platelet derivatives on the treatment of human periodontal intrabony defects.Methods A search in PubMed, Web of Science, Embase, Cochrane Library, CNKI, and other electronic databases was conducted to iden-tify randomized controlled trials (RCT) of the use of DFDBA combined with rich platelet derivatives in the treatment of human periodontal intrabony defects, performed before May 2016. The quality of the RCTs was assessed.RevMan 5.3 software was applied for Meta-analysis.Results A total of nine RCTs were included. A total of 194 patients and 303 defects were involved. Short-term (6 months) and long-term (12 to 18 months) groups were included. Meta-analysis results revealed that DFDBA combined with rich platelet derivatives was superior to DFDBA or rich platelet derivatives alone for probing depth reduction in the short-term MD=0.75 mm, 95% confidence intervals (CI) (0.31 mm, 1.20 mm),P=0.0010] and long-term groups MD=0.87 mm, 95%CI (0.02 mm, 1.72 mm),P=0.04], clinical attachment level gain in the short-term MD=0.65 mm, 95%CI (0.08 mm, 1.22 mm),P=0.03] and long-term groups MD=1.31 mm, 95%CI (0.60 mm, 2.01 mm),P<0.0003], gingival recession reduction in the long-term group MD=-0.58 mm, 95%CI (-0.78 mm, -0.38mm),P<0.00001], bone fill gain in the short-term MD=0.52 mm, 95%CI (0.03 mm, 1.00 mm),P=0.04] and long-term groups MD=1.26 mm, 95%CI (0.65 mm, 1.86 mm),P<0.0001].Conclusion DFDBA combined with platelet rich derivatives is probably effective in the treatment of human periodontal intrabony defects. It is probably superior to DFDBA or platelet rich derivatives alone. Consi-dering the limitation of the included studies, high-quality and large-sample RCTs are required to evaluate the effect.