釉基质蛋白治疗牙周骨内缺损的系统评价

Enamel matrix proteins in the treatment of intrabony defects:A cochrane systematic review

目的:比较并评价釉基质蛋白治疗牙周病骨内缺损的临床效果是否优于单用屏障膜的引导组织再生术。方法:主要检索7个数据库,部分全文通过手工检索获得。收集1997—2008年公开发表的中、英文釉基质蛋白及引导组织再生术的随机对照试验,随访时间至少半年。最终11个研究纳入系统评价。利用Meta分析,综合筛选出11篇适用文献。进行综合分析的测量结果包括术后牙周袋探诊深度(PD)减少、附着水平(CAL)增加、牙龈退缩水平(REC)的变化。结果:Meta分析结果显示,3种临床测量指标的基线水平在2治疗组间具有可比性,≥6个月后,3项指标的临床效果在2治疗组间比较无统计学差异。结论:现有的证据支持在牙周袋探诊深度减少、附着水平增加、牙龈退缩3项指标方面,釉基质蛋白治疗牙周病骨内缺损可取得与引导组织再生术相似的临床效果。

PURPOSE： The purpose of this study was to systematically review the evidence for efficacy of enamel matrix proteins （EMPs） in comparison with guided tissue regeneration（GTR） for the treatment of intrabony defects. METHODS： The selected studies were pooled from seven major electronic databases from 1997 to 2008 for randomized controlled trials （RCTs） with at least 6 months of follow-up. Several English journals were hand-searched. ]n addition, a Meta-analysis was presented regarding the clinical results during regeneration with EMPs or GTR. Outcome measures were probing depth （PD） reduction, clinical attachment level （CAL） gain, and gingival recession（GR）. RESULTS： A recta-analysis showed that the baseline between the two groups were comparative, but there were no statistieal significant differences in PD reduction and CAL gain and GR was observed between the two regenerative treatments. CONCLUSIONS： There is no evidence of important differences between EMPs and GTR in PD reduction, CAL gain and GR. EMPs can gain the similar clinical effects as GTR when treated with intrabony defects.Supported by Research Project of Education Bureau of Liaoning Province （Grant No.20061021）.