CAJ | 학술논문

背景：理论上将可吸收胶原膜应用于牙槽突裂二期植骨可提高移植骨的保存率，减缓骨吸收，然而目前所报道的研究结果并不一致。 　　目的：系统评价可吸收胶原膜在牙槽突裂二期植骨中的作用与安全性。 　　方法：应用计算机电子检索Medline、荷兰医学文摘、中国生物医学文献数据库和中国学术期刊网络出版总库，同时对文献的引文进行追索，获取研究可吸收胶原膜对牙槽突裂二期植骨作用的临床随机对照试验和临床对照试验，试验组接受可吸收胶原膜的骨移植物，对照组仅接受骨移植物，对两组植骨临床成功率、受区并发症发生率进行Meta分析。 　　结果与结论：最终纳入文献5篇，共387例患者，涉及植骨裂隙416侧。Meta分析显示，以新骨形成高度≥牙槽突高度50%为标准定义植骨临床成功率，试验组植骨临床成功率高于对照组(P=0.002，相对危险度RR=1.33，95%可信区间[1.11，1.60])；以新骨形成高度≥牙槽突高度75%为标准定义植骨临床成功率，试验组植骨临床成功率虽高于对照组，但差异无显著性意义(P=0.06，相对危险度RR=1.40，95%可信区间[0.99，1.99])；两组受区并发症发生率无差异(P=0.35，相对危险度 RR=0.66，95%可信区间[0.28，1.58])。表明使用可吸收胶原膜能提高牙槽突裂二期植骨的临床成功率，并且是安全的，该结论还需要更多临床随机对照试验的证实。
배경：이론상장가흡수효원막응용우아조돌렬이기식골가제고이식골적보존솔，감완골흡수，연이목전소보도적연구결과병불일치。 　　목적：계통평개가흡수효원막재아조돌렬이기식골중적작용여안전성。 　　방법：응용계산궤전자검색Medline、하란의학문적、중국생물의학문헌수거고화중국학술기간망락출판총고，동시대문헌적인문진행추색，획취연구가흡수효원막대아조돌렬이기식골작용적림상수궤대조시험화림상대조시험，시험조접수가흡수효원막적골이식물，대조조부접수골이식물，대량조식골림상성공솔、수구병발증발생솔진행Meta분석。 　　결과여결론：최종납입문헌5편，공387례환자，섭급식골렬극416측。Meta분석현시，이신골형성고도≥아조돌고도50%위표준정의식골림상성공솔，시험조식골림상성공솔고우대조조(P=0.002，상대위험도RR=1.33，95%가신구간[1.11，1.60])；이신골형성고도≥아조돌고도75%위표준정의식골림상성공솔，시험조식골림상성공솔수고우대조조，단차이무현저성의의(P=0.06，상대위험도RR=1.40，95%가신구간[0.99，1.99])；량조수구병발증발생솔무차이(P=0.35，상대위험도 RR=0.66，95%가신구간[0.28，1.58])。표명사용가흡수효원막능제고아조돌렬이기식골적림상성공솔，병차시안전적，해결론환수요경다림상수궤대조시험적증실。
BACKGROUND:Absorbable colagen membrane can be theoreticaly applied to secondary alveolar bone grafting in alveolar cleft surgery, which can improve the bone preservation and slow bone resorption. However, there is stil no unified conclusion. OBJECTIVE:To assess the efficacy and safety of absorbable colagen membrane for secondary alveolar bone grafting viaa systematic review. METHODS:MEDLINE, EMBASE, CBM and CAJD were searched for eligible articles addressing clinical randomized controled or controled trials of absorbable colagen membrane for secondary alveolar bone grafting. Test group received bone grafting with absorbable colagen membrane and control group only received bone grafting. Meta-analysis on the clinical success rate of bone grafting and incidence of complications in the recipient region was delivered with Revman 5.3. RESULTS AND CONCLUSION:Five clinical trials, involving 416 cleft sites and 387 participants, were included. Two had high risk of bias and the rest had unclear risk of bias. If “the height of new bone is≥ 50% of alveolar height” was adopted as clinical success, the clinical success rate of the test group was significantly higher than that of the control group (P=0.002, relative risk value=1.33, 95% confidence interval [1.11, 1.60]). If “the height of new bone is≥ 75% of alveolar height” was chosen as clinical success, the clinical success rate of the test group was higher than that of the control group, but there was no significant difference between the two groups (P=0.06, relative risk value=1.40, 95% confidence interval [0.99, 1.99]). For safety, the use of absorbable colagen membrane could not increase the complications incidence (P=0.35, relative risk value=0.66, 95% confidence interval [0.28, 1.58]). So, the use of absorbable colagen membrane is safe to improve the clinical success rate of secondary alveolar bone grafting in alveolar cleft surgery. More randomized controled trials should be considered to reinforce the conclusion.