Methodological Appraisal and Evidence-Based Insights on Guided Tissue Regeneration in Endodontic Surgery: An Umbrella Review of Systematic Reviews and Meta-Analyses.

IF 1.5 4区医学 Q3 DENTISTRY, ORAL SURGERY & MEDICINE

Australian Endodontic Journal Pub Date : 2025-06-30 DOI:10.1111/aej.12967

Rahul Sharma, Kanaga Durga, Harshita Wadhwa, Saurabh Kumar Gupta

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引用次数: 0

Abstract

This study evaluated the methodological quality and synthesised evidence from systematic reviews on guided tissue regeneration (GTR) in endodontic surgery. A comprehensive search across multiple databases was conducted to identify systematic reviews published up to 21 November 2024, with no language restrictions. Methodological quality was assessed using the AMSTAR-2 tool, and primary study overlap using corrected covered area (CCA) metrics. Fourteen systematic reviews, including eight meta-analyses, were included. The CCA was 12.77%, indicating high overlap, and AMSTAR-2 revealed considerable methodological variability. The use of GTR, especially the combination of bone grafts and resorbable membranes, showed improved healing outcomes in through-and-through lesions. Adjunctive use of platelet concentrates appeared to enhance postoperative recovery. However, heterogeneity in study designs and the absence of long-term follow-up limit the strength of conclusions. Overall, GTR techniques, particularly those combining grafts and membranes, show promise in endodontic surgery, but more rigorous, well-designed studies and systematic reviews are required to reinforce clinical recommendations. Trial Registration: International Prospective Register of Systematic Reviews (PROSPERO) CRD42024546481.

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根管手术中引导组织再生的方法学评价和循证见解：系统评价和荟萃分析的综述。

本研究评估了根管手术中引导组织再生（GTR）的方法学质量和综合证据。在多个数据库中进行了全面搜索，以确定截至2024年11月21日发表的系统评论，没有语言限制。使用AMSTAR-2工具评估方法学质量，使用校正覆盖面积（CCA）指标评估初步研究重叠。纳入了14项系统综述，包括8项荟萃分析。CCA为12.77%，表明高度重叠，AMSTAR-2显示出相当大的方法差异。GTR的使用，特别是骨移植物和可吸收膜的结合，显示了贯通病变的愈合效果。辅助使用血小板浓缩物似乎可以促进术后恢复。然而，研究设计的异质性和缺乏长期随访限制了结论的强度。总的来说，GTR技术，特别是那些结合移植物和膜的技术，在牙髓手术中显示出希望，但需要更严格、设计良好的研究和系统评价来加强临床推荐。试验注册：国际前瞻性系统评价注册（PROSPERO） CRD42024546481。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Australian Endodontic Journal DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

3.50

自引率

6.20%

发文量

审稿时长

>12 weeks

期刊介绍： The Australian Endodontic Journal provides a forum for communication in the different fields that encompass endodontics for all specialists and dentists with an interest in the morphology, physiology, and pathology of the human tooth, in particular the dental pulp, root and peri-radicular tissues. The Journal features regular clinical updates, research reports and case reports from authors worldwide, and also publishes meeting abstracts, society news and historical endodontic glimpses. The Australian Endodontic Journal is a publication for dentists in general and specialist practice devoted solely to endodontics. It aims to promote communication in the different fields that encompass endodontics for those dentists who have a special interest in endodontics.