阻生下颌第三磨牙拔除同期植骨治疗邻牙远中牙周缺损疗效的Meta分析
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摘要
目的:评价阻生下颌第三磨牙拔除术同期植骨术治疗第二磨牙远中牙周缺损的疗效。方法:计算机检索Cochrane library、PubMed、EMBASE、web of science、中国知网、万方、维普,手工检索Journal of Periodontology、Journal of Oral and Maxillofacial Surgery杂志,查找植骨术治疗第二磨牙远中牙周缺损的相关文献,检索至2018年5月28日。采用RevMan 5. 3和Stata 12. 0进行Meta分析。结果:纳入7个随机对照研究,Meta分析结果显示,术前第二磨牙远中PD≥4 mm者,拔除下颌阻生第三磨牙同期植骨较不植骨者对于第二磨牙远中探诊深度(probing depth,PD)减少更为明显(P<0. 000 01),临床附着水平(clinical attachment level,CAL)获得更加显著(P<0. 000 01);术前第二磨牙远中PD<4 mm者,拔除下颌阻生第三磨牙同期植骨或是不植骨对于第二磨牙远中PD的改善效果无差异(P=0. 77).结论:当术前第二磨牙远中牙周探诊深度较深时,下颌阻生第三磨牙拔除术同期植骨较不植骨者更有利于第二磨牙远中牙周缺损的愈合。
Objective: To evaluate the efficacy of bone grafting for treatment of periodontal defects distal to the second molar after removal of impacted mandibular third molar. Methods: Online search combined with manual retrieval was conducted up to 2018 to collect the relevant literatures referring to bone grafting and impacted mandibular third molar extraction. Probing depth( PD) and clinical attachment level( CAL) were analyzed. Meta-analysis was performed using Rev Man 5. 3 and Stata/SE version 12. 0 software. Results: A total of 7 RCTs were included. The results of meta-analysis showed that,when the PD≥4 mm distal to the second molar,impacted mandibular third molar extraction combined with bone grafting showed significant additional probing depth reduction( P<0. 000 01) and significant clinical attachment gain( P<0. 000 01) compared with impacted mandibular third molar extraction alone. Nevertheless,the difference cannot be proved if the PD<4 mm distal to the second molar perioperatively( P = 0. 77). Conclusion: Current evidences show that,if the PD≥4 mm distal to the second molar before operation,with regard to the treatment of periodontal defects distal to the second molar,bone grafting has a significant additional effect than impacted mandibular third molar extraction alone.
Objective: To evaluate the efficacy of bone grafting for treatment of periodontal defects distal to the second molar after removal of impacted mandibular third molar. Methods: Online search combined with manual retrieval was conducted up to 2018 to collect the relevant literatures referring to bone grafting and impacted mandibular third molar extraction. Probing depth( PD) and clinical attachment level( CAL) were analyzed. Meta-analysis was performed using Rev Man 5. 3 and Stata/SE version 12. 0 software. Results: A total of 7 RCTs were included. The results of meta-analysis showed that,when the PD≥4 mm distal to the second molar,impacted mandibular third molar extraction combined with bone grafting showed significant additional probing depth reduction( P<0. 000 01) and significant clinical attachment gain( P<0. 000 01) compared with impacted mandibular third molar extraction alone. Nevertheless,the difference cannot be proved if the PD<4 mm distal to the second molar perioperatively( P = 0. 77). Conclusion: Current evidences show that,if the PD≥4 mm distal to the second molar before operation,with regard to the treatment of periodontal defects distal to the second molar,bone grafting has a significant additional effect than impacted mandibular third molar extraction alone.
引文
[1]Laskin DM.Evaluation of the third molar problem[J].J Am Dent Assoc,1971,82(4):824-828.
[2]Qu HL,Tian BM,Li K,et al.Effect of asymptomatic visible third molars on periodontal health of adjacent second molars:A cross-sectional study[J].J Oral Maxillofac Surg,2017,75(10):2048-2057.
[3]Toedtling V,Coulthard P,Thackray G.Distal caries of the second molar in the presence of a mandibular third molar-a prevention protocol[J].Br Dent J,2016,221(6):297-302.
[4]Deliverska EG.Management of mandibular third molar surgery to preserve periodontal health of second molar[J].J of IMAB,2017,23(2):1579-1583.
[5]Coleman M,Mccormick A,Laskin DM.The incidence of periodontal defects distal to the maxillary second molar after impacted third molar extraction[J].J Oral Maxillofac Surg,2011,69(2):319-321.
[6]高云飞,郭良微,周晋,等.富血小板血浆联合植骨材料与单用植骨材料比较治疗牙周病骨内缺损疗效的Meta分析[J].中国循证医学杂志,2013,13(6):741-746.
[7]de Melo DG,de Santana Santos T,Sehn FP,et al.Evaluation of inorganic bovine bone graft in periodontal defects after third molar surgery[J].Ann Maxillofac Surg,2015,5(2):198-202.
[8]Tabrizi R,Khorshidi H,Shahidi S,et al.Use of lincomycin-impregnated demineralized freeze-dried bone allograft in the periodontal defect after third molar surgery[J].J Oral Maxillofac Surg,2014,72(5):850-857.
[9]Hassan KS,Marei HF,Alagl AS.Does grafting of third molar extraction sockets enhance periodontal measures in 30-to 35-year-old patients?[J].J Oral Maxillofac Surg,2012,70(4):757-764.
[10]Sammartino G,Tia M,Bucci T,et al.Prevention of mandibular third molar extraction associated periodontal defects:A comparative study[J].J Periodontol,2009,80(3):389-396.
[11]Dodson TB.Management of mandibular third molar extraction sites to prevent periodontal defects[J].J Oral Maxillofac Surg,2004,62(10):1213-1224.
[12]杨孝勤,陈军,马伟群,等.可注射性磷酸钙骨水泥修复下颌阻生第三磨牙微创拔除后牙槽骨缺损[J].四川生理科学杂志,2014,36(3):105-108.
[13]陈慧娟,肖国岫.下颌第三磨牙拔除同期植骨术对邻牙远中成骨的影响[J].口腔颌面外科杂志,2017,27(2):131-135.
[14]Dutta SR,Passi D,Singh P,et al.A randomized comparative prospective study of platelet-rich plasma,platelet-rich fibrin,and hydroxyapatite as a graft material for mandibular third molar extraction socket healing[J].Nat J Maxillofac Surg,2016,7(1):45-51.
[15]Arenaz-Búa J,Luaces-Rey R,Sironvalle-Soliva S,et al.A comparative study of platelet-rich plasma,hydroxyapatite,demineralized bone matrix and autologous bone to promote bone regeneration after mandibular impacted third molar extraction[J].Med Oral Patol Oral Cir Bucal,2010,15(3):e483.
[16]Gürbüzer B,Pikd9ken L,Urhan M,et al.Scintigraphic evaluation of early osteoblastic activity in extraction sockets treated with platelet-rich plasma[J].J Oral Maxillofac Surg,2008,66(12):2454-2460.
[17]Bilginaylar K,Uyanik LO.Evaluation of the effects of platelet-rich fibrin and piezosurgery on outcomes after removal ofmpacted mandibular third molars[J].Br J Oral Maxillofac Surg,2016,54(6):629-633.
[18]Karapataki S,Hugoson A,Kugelberg CF.Healing following GTR treatment of bone defects distal to mandibular 2 nd molars after surgical removal of impacted 3 rd molars[J].J Clin Periodontol,2010,27(5):325-332.
[19]Dodson TB.Reconstruction of alveolar bone defects after extraction of mandibular third molars:a pilot study[J].Oral Surg Oral Med Oral Pathol Oral Radiol Endod,1996,82(3):241-247.
[20]Throndson RR,Sexton SB.Grafting mandibular third molar extraction sites:a comparison of bioactive glass to a nongrafted site[J].Surg Oral Med Oral Pathol Oral Radiol Endod,2002,94(4):413-419.
[21]Ge J,Yang C,Zheng J,et al.Autogenous bone grafting for treatment of osseous defect after impacted mandibular third molar extraction:A randomized controlled trial[J].Clin Implant Dent Relat Res,2017,19(3):572-580.
[22]Guida L,Cuccurullo GP,Lanza A,et al.Orthodontic-aided extraction of impacted third molar to improve the periodontal status of the neighboring tooth[J].J Craniofac Surg,2011,22(5):1922-1924.
[23]戈旌,杨驰,郑家伟,等.下颌阻生第三磨牙拔除术后第二磨牙远中骨质缺损治疗进展[J].中国口腔颌面外科杂志,2016,14(1):76-82.
[24]Petsos H,Korte J,Eickholz P,et al.Surgical removal of third molars and periodontal tissues of adjacent second molars[J].J Clin Periodontol,2016,43(5):453-460.
[25]Al-Hamed FS,Tawfik AM,Abdelfadil E.Clinical effects of platelet-rich fibrin(PRF)following surgical extraction of lower third molar[J].SJDR,2017,8(1-2):19-25.
[26]Varghese MP,Manuel S,Kumar S.Potential for osseous regeneration of platelet rich fibrin:a comparative study in third molar impaction sockets[J].J Oral Maxillofac Surg,2017,75(7):1322-1329.
[27]陈志方.骨组织工程支架材料充填下颌阻生智牙拔牙窝的临床效果[J].上海口腔医学,2011,20(1):93-96.
[28]Azariah EDS,Evangeline A,Chinnasami R.Comparison of tooth derived hydroxyapatite with commercially pure hydroxyapatite[J].International J Oral Maxillofac Surg,2017,46:365.
[2]Qu HL,Tian BM,Li K,et al.Effect of asymptomatic visible third molars on periodontal health of adjacent second molars:A cross-sectional study[J].J Oral Maxillofac Surg,2017,75(10):2048-2057.
[3]Toedtling V,Coulthard P,Thackray G.Distal caries of the second molar in the presence of a mandibular third molar-a prevention protocol[J].Br Dent J,2016,221(6):297-302.
[4]Deliverska EG.Management of mandibular third molar surgery to preserve periodontal health of second molar[J].J of IMAB,2017,23(2):1579-1583.
[5]Coleman M,Mccormick A,Laskin DM.The incidence of periodontal defects distal to the maxillary second molar after impacted third molar extraction[J].J Oral Maxillofac Surg,2011,69(2):319-321.
[6]高云飞,郭良微,周晋,等.富血小板血浆联合植骨材料与单用植骨材料比较治疗牙周病骨内缺损疗效的Meta分析[J].中国循证医学杂志,2013,13(6):741-746.
[7]de Melo DG,de Santana Santos T,Sehn FP,et al.Evaluation of inorganic bovine bone graft in periodontal defects after third molar surgery[J].Ann Maxillofac Surg,2015,5(2):198-202.
[8]Tabrizi R,Khorshidi H,Shahidi S,et al.Use of lincomycin-impregnated demineralized freeze-dried bone allograft in the periodontal defect after third molar surgery[J].J Oral Maxillofac Surg,2014,72(5):850-857.
[9]Hassan KS,Marei HF,Alagl AS.Does grafting of third molar extraction sockets enhance periodontal measures in 30-to 35-year-old patients?[J].J Oral Maxillofac Surg,2012,70(4):757-764.
[10]Sammartino G,Tia M,Bucci T,et al.Prevention of mandibular third molar extraction associated periodontal defects:A comparative study[J].J Periodontol,2009,80(3):389-396.
[11]Dodson TB.Management of mandibular third molar extraction sites to prevent periodontal defects[J].J Oral Maxillofac Surg,2004,62(10):1213-1224.
[12]杨孝勤,陈军,马伟群,等.可注射性磷酸钙骨水泥修复下颌阻生第三磨牙微创拔除后牙槽骨缺损[J].四川生理科学杂志,2014,36(3):105-108.
[13]陈慧娟,肖国岫.下颌第三磨牙拔除同期植骨术对邻牙远中成骨的影响[J].口腔颌面外科杂志,2017,27(2):131-135.
[14]Dutta SR,Passi D,Singh P,et al.A randomized comparative prospective study of platelet-rich plasma,platelet-rich fibrin,and hydroxyapatite as a graft material for mandibular third molar extraction socket healing[J].Nat J Maxillofac Surg,2016,7(1):45-51.
[15]Arenaz-Búa J,Luaces-Rey R,Sironvalle-Soliva S,et al.A comparative study of platelet-rich plasma,hydroxyapatite,demineralized bone matrix and autologous bone to promote bone regeneration after mandibular impacted third molar extraction[J].Med Oral Patol Oral Cir Bucal,2010,15(3):e483.
[16]Gürbüzer B,Pikd9ken L,Urhan M,et al.Scintigraphic evaluation of early osteoblastic activity in extraction sockets treated with platelet-rich plasma[J].J Oral Maxillofac Surg,2008,66(12):2454-2460.
[17]Bilginaylar K,Uyanik LO.Evaluation of the effects of platelet-rich fibrin and piezosurgery on outcomes after removal ofmpacted mandibular third molars[J].Br J Oral Maxillofac Surg,2016,54(6):629-633.
[18]Karapataki S,Hugoson A,Kugelberg CF.Healing following GTR treatment of bone defects distal to mandibular 2 nd molars after surgical removal of impacted 3 rd molars[J].J Clin Periodontol,2010,27(5):325-332.
[19]Dodson TB.Reconstruction of alveolar bone defects after extraction of mandibular third molars:a pilot study[J].Oral Surg Oral Med Oral Pathol Oral Radiol Endod,1996,82(3):241-247.
[20]Throndson RR,Sexton SB.Grafting mandibular third molar extraction sites:a comparison of bioactive glass to a nongrafted site[J].Surg Oral Med Oral Pathol Oral Radiol Endod,2002,94(4):413-419.
[21]Ge J,Yang C,Zheng J,et al.Autogenous bone grafting for treatment of osseous defect after impacted mandibular third molar extraction:A randomized controlled trial[J].Clin Implant Dent Relat Res,2017,19(3):572-580.
[22]Guida L,Cuccurullo GP,Lanza A,et al.Orthodontic-aided extraction of impacted third molar to improve the periodontal status of the neighboring tooth[J].J Craniofac Surg,2011,22(5):1922-1924.
[23]戈旌,杨驰,郑家伟,等.下颌阻生第三磨牙拔除术后第二磨牙远中骨质缺损治疗进展[J].中国口腔颌面外科杂志,2016,14(1):76-82.
[24]Petsos H,Korte J,Eickholz P,et al.Surgical removal of third molars and periodontal tissues of adjacent second molars[J].J Clin Periodontol,2016,43(5):453-460.
[25]Al-Hamed FS,Tawfik AM,Abdelfadil E.Clinical effects of platelet-rich fibrin(PRF)following surgical extraction of lower third molar[J].SJDR,2017,8(1-2):19-25.
[26]Varghese MP,Manuel S,Kumar S.Potential for osseous regeneration of platelet rich fibrin:a comparative study in third molar impaction sockets[J].J Oral Maxillofac Surg,2017,75(7):1322-1329.
[27]陈志方.骨组织工程支架材料充填下颌阻生智牙拔牙窝的临床效果[J].上海口腔医学,2011,20(1):93-96.
[28]Azariah EDS,Evangeline A,Chinnasami R.Comparison of tooth derived hydroxyapatite with commercially pure hydroxyapatite[J].International J Oral Maxillofac Surg,2017,46:365.