1.Effects of guided tissue regeneration combined with bone graft in the repair of periodontal bone defects:a Meta-analysis
Yue SHEN ; Panlong HE ; Yiru WEI
Chinese Journal of Tissue Engineering Research 2017;21(4):641-649
BACKGROUND:Guided tissue regeneration and bone grafting are a hot spot in the treatment of periodontal bone defect caused by severe periodontitis, but a smal sample size in clinical research wil lead to bias. OBJECTIVE:To systematical y evaluate the effect of guided tissue regeneration combined with bone grafting in the treatment of periodontal bone defect, and explore its feasibility, thus providing evidence for clinical application. METHODS:A computer-based search of PubMed, Cochrane Library, EMbase, CNKI, CqVip and WanFang databases was performed for articles about the guided tissue regeneration and bone graft for periodontal bone defects, published from 2000 to 2016. The keywords were“guided tissue regeneration, bone grafts, periodontal bone defects”in English and Chinese, respectively. The literature selection, data col ection and evaluation of bias were conducted by two researchers independently, and then quality assessment of the included 12 randomized control ed tests was conducted, fol owed by Meta-analysis using Revman 5.3 software. RESULTS AND CONCLUSION:A total of 12 studies were enrol ed, including 414 teeth (228 of which in the experimental group and 216 in the control group). Meta-analysis results showed that compared with the single flap surgery, guided tissue regeneration combined with bone graft could reduce periodontal probing depth by 1.18 mm gingival, make a gingival recession by 0.23 mm, reduce alveolar bone defect depth by 1.57 mm, and increase clinical attachment level by 2.03 mm (P<0.05). Compared with guided tissue regeneration technique, guided tissue regeneration combined with bone graft made probing depth increase by 0.34 mm, alveolar bone defect depth reduce by 0.73 mm, gingival recession reduce 0.35 mm and clinical attachment level increase by 0.63 mm (P<0.05). Compared with bone graft, guided tissue regeneration combined with bone graft made periodontal probing depth reduce by 0.11 mm, clinical attachment levels increase by 0.04 mm and gingival recession increase by 0.13 mm (P>0.05). These results reveal that for moderate to severe chronic periodontitis with periodontal bone defects, guided tissue regeneration combined with bone graft has better clinical effects than simply flap surgery and guided tissue regeneration, but has no significant differences from the bone graft surgery. Herein, we have not yet classified the membrane materials, bone materials and bone substitutes, and there is stil a lack of high-quality and large-sample randomized control ed trials.