中国实用口腔科杂志

中国实用口腔科杂志 ›› 2024, Vol. 17 ›› Issue (3): 284-293.DOI: 10.19538/j.kq.2024.03.005

• 论著 • 上一篇    下一篇

自体血小板浓缩物作为单一移植物在上颌窦底提升术中应用效果Meta分析

刘秋阳, 蓝斯群, 许鼎炜, 梁俊威, 单誉晨, 林海燕   

  1. 1. 浙江中医药大学口腔医学院，浙江  杭州  310053；2. 杭州医学院存济口腔医学院，浙江  杭州  311399
  • 出版日期:2024-05-01 发布日期:2024-05-30
  • 通讯作者: 林海燕
  • 基金资助:
    浙江省“领雁”研发攻关计划（2023C03070）

  • Online:2024-05-01 Published:2024-05-30

摘要： 目的    分析在上颌窦底提升术（maxillary sinus floor augmentation，MSFA）中应用自体血小板浓缩物（autogenous platelet concentrates，APCs）作为单一移植物的临床效果。方法    计算机检索PubMed、Web of Science、Cochrane Library、EMbase、CBM、VIP、中国知网和万方数据库，检索时间为建库至2023-07-30。查找在MSFA同期植入种植体中将APCs作为单一移植物（研究组）与相同术式无其他移植材料（对照组）的临床效果比较研究，分析APCs对上颌窦底骨增量、上颌窦底高度变化、种植体存留率及术后并发症的影响。应用RevMan 5.4软件对数据进行Meta分析。结果    共纳入8篇相关文献，其中随机对照试验6篇，临床对照试验2篇。Meta分析结果显示，术后12个月，研究组种植体周围、种植体近中、种植体远中上颌窦底骨增量均大于对照组，差异均有统计学意义（种植体周围：MD = 0.76 mm，95%CI：0.33 ~ 1.19 mm，P < 0.001；种植体近中：MD = 1.27 mm，95%CI：1.01 ~ 1.53 mm，P < 0.001；种植体远中：MD = 1.35 mm，95%CI：1.06 ~ 1.64 mm，P < 0.001）。术后6、12个月，研究组上颌窦底骨高度变化小于对照组，差异有统计学意义（术后6个月：MD = 0.42 mm，95%CI：0.10 ~ 0.74 mm，P = 0.01；术后12个月：MD = 1.86 mm，95%CI：1.40 ~ 2.32 mm，P < 0.001）。2组种植体存留率均为100%，且无MSFA相关并发症发生。结论    APCs应用于MSFA中可增加上颌窦底骨量，减缓上颌窦底骨高度下降，对种植体的存留和疗效的稳定具有积极作用。

关键词: Meta分析, 上颌窦底提升术, 自体血小板浓缩物, 种植体

Abstract: Objective    To analyze the clinical effects of using autogenous platelet concentrates（APCs）as a sole graft in maxillary sinus floor augmentation（MSFA）. Methods    The computer search was conducted in PubMed，Web of Science，Cochrane Library，EMbase，CBM，VIP，CNKI，and Wanfang databases，the time period being from the establishment of the databases until July 30，2023. The objective was to identify comparative clinical studies within the context of MSFA，specifically focusing on the simultaneous implantation of APCs as a sole graft（study group）versus the same procedure without any other graft materials（control group）. The analysis aimed to evaluate the impact of APCs on bone augmentation in the maxillary sinus floor，changes in maxillary sinus floor height，implant survival rates，and postoperative complications. The collected data were subjected to Meta-analysis using RevMan 5.4. Results    A total of 8 relevant articles were included in the analysis，comprising 6 randomized controlled trials and 2 clinical controlled trials. The Meta-analysis results revealed that at 12 months postoperatively，the study group exhibited significantly greater bone augmentation around the implants，in the vicinity of the implants，and in the far-middle region of the maxillary sinus floor compared to the control group. The differences were statistically significant（around implants：MD = 0.76 mm，95%CI：0.33 - 1.19 mm，P < 0.001；near implants：MD = 1.27 mm，95%CI：1.01 - 1.53 mm，P < 0.001；far-middle implants：MD = 1.35 mm，95%CI：1.06 - 1.64 mm，P < 0.001）. At 6 and 12 months postoperatively，the study group exhibited less change in maxillary sinus floor height compared to the control group，and the differences were statistically significant（at 6 months postoperatively：MD = 0.42 mm，95%CI：0.10 - 0.74 mm，P = 0.01；at 12 months postoperatively：MD = 1.86 mm，95%CI：1.40 - 2.32 mm，P < 0.001）. Both groups demonstrated a 100% implant survival rate，and no MSFA-related complications were reported. Conclusion    The application of APCs in MSFA can increase bone augmentation in the maxillary sinus floor，slow down the descent of maxillary sinus floor height，and contribute positively to the stability of implant retention and efficacy.

Key words: Meta-analysis, maxillary sinus floor augmentation, autogenous platelet concentrates, dental implant