釉基质蛋白衍生物联合植骨材料与单用植骨材料比较治疗牙周骨缺损疗效的Meta分析

The effects of bone graft combined with enamel matrix derivative in the treatment of periodontal osseous defects compared with that of bone graft alone:A meta-analysis

目的:比较并评价釉基质蛋白衍生物联合植骨材料与单用植骨材料治疗牙周骨缺损的临床效果。方法:在Cochrane Library、EMBASE、Pub Med、CNKI、万方、Google学术等中外文数据库检索2016-05前发表的关于釉基质蛋白衍生物联合植骨材料治疗牙周骨缺损的随机对照临床研究,对纳入的文献进行质量评价,应用RevMan 5.3软件对数据进行Meta分析。结果:最终纳入5篇RCT文献,共145个牙周骨缺损位点。Meta分析结果显示,6月组,试验组较对照组可明显降低牙周袋探诊深度(WMD=0.40,95%CI=[0.01,0.79],P<0.05),增加临床附着水平(WMD=0.50,95%CI=[0.12,0.88],P<0.05);12月组,2指标的临床效果在2组间比较无统计学差异。结论:釉基质蛋白联合植骨材料比单纯使用植骨材料对治疗牙周骨内缺损显示,在短期随访期间,联合疗法的在探诊深度及临床附着水平有显著优势;长期随访期间,各临床结果2组之间差异无显著性。

Objective:To analyze the efficacy of enamel matrix derivative(EMD)combined with bone grafts in the treatment of periodontal osseous defects comparied with that of bone grafts alone by Meta-analysis.Methods:The randomized controlled trials (RCTs)about the efficacy of enamel matrix derivative.and bone grafts for the treatment of periodontal osseous defects were collected from Coehrane Library,EMBASE,PubMed,CNKI,Wanfang databases and Google scholar from inception may,2016by.electronic search,scored literatures with the methodological index for non-randomized studies(MINORS)evaluation tool Revman5.3was used for the Meta-analysis.Results:5RCTs articles with145cases were included.Meta-analysis showed that:at6months of follow-up, PD reduction and CAL gain was found more in test group than in control group(WMD=0.40,95%CI=[0.01,0.79],P<0.05) and(WMD=0.50,95%CI=[0.12,0.88],P<0.05)respectively.At12months of follow-up,there was no statistical significant difference in PD reduction and CAL gain respeofively between the2treatments.Conclusion:The combined use of EMD and bone grafts may improve PD reduction and CAL gain in the early stage of convalescence following treatment of periodontal osseous deflects.