牙周再生疗法中的患者报告结果测量和卫生经济学:系统回顾和荟萃分析。

IF 17.5 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE
Zhaozhao Chen, Cho-Ying Lin, Hom-Lay Wang
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引用次数: 0

摘要

了解患者对牙周再生的反应至关重要。本系统综述和荟萃分析探讨了两个关键问题:(a) 牙周再生对患者报告的骨内和毛囊受累结果测量(PROMs)的影响;(b) 牙周再生治疗牙周缺损的成本效益。共纳入 24 项研究,其中 20 项随机临床试验(RCT)报告了患者报告结果,5 项(3 项 RCT 和 2 项基于经济模型的研究)报告了成本效益结果。结果显示,再生疗法比传统的骨内缺损翻瓣手术更受青睐,在定性(即再生附着器的数量)和定量参数(即探查和放射学参数)方面均有改善。在PROMs方面,与使用生物制剂的皮瓣或单独使用通路皮瓣相比,使用屏障膜的再生治疗需要更长的椅位时间,并发症(如膜暴露或水肿)的发生率也更高。尽管如此,再生和拔牙术后与口腔健康相关的生活质量都有所提高。从经济角度看,与牙周缺损的拔牙和置换术或单纯的开放瓣清创术相比,再生术仍具有优势。开放瓣清创术中的单瓣变体与再生治疗的结果相似,提供了一种具有潜在成本效益的选择。不过,由于缺乏组织学评估,还需要进一步讨论创伤较小的翻瓣设计的益处。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Patient-reported outcome measures and health economics in regenerative periodontal therapy: A systematic review and meta-analysis.

Understanding patient responses to periodontal regeneration is crucial. This systematic review and meta-analysis addressed two key questions: (a) the impact of periodontal regeneration on patient-reported outcome measures (PROMs) for intrabony and furcation involvement and (b) the cost-effectiveness of periodontal regeneration for treating periodontal defects. Twenty-four studies were included, with 20 randomized clinical trials (RCTs) reporting patient-reported outcomes and five (three RCTs and two economic model-based studies) reporting cost-effectiveness outcomes. Results favored regeneration therapy over conventional flap surgery for intrabony defects, showing improvements in qualitative (i.e., amount of regenerated attachment apparatus) and quantitative parameters (i.e., probing and radiographic parameters). In terms of PROMs, regenerative treatments involving barrier membranes resulted in longer chair times and higher rates of complications (such as membrane exposure or edema) compared to flap with biologic agents or access flap alone. Despite this, oral health-related quality of life improved after both regenerative and extraction procedures. Economically, regeneration remained favorable compared to extraction and replacement or open flap debridement alone for periodontal defects. Single-flap variants in open flap debridement yielded similar outcomes to regenerative treatment, offering a potentially cost-effective option. Nevertheless, further discussion on the benefits of less-invasive flap designs is needed due to the lack of histological evaluation.

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来源期刊
Periodontology 2000
Periodontology 2000 医学-牙科与口腔外科
CiteScore
34.10
自引率
2.20%
发文量
62
审稿时长
>12 weeks
期刊介绍: Periodontology 2000 is a series of monographs designed for periodontists and general practitioners interested in periodontics. The editorial board selects significant topics and distinguished scientists and clinicians for each monograph. Serving as a valuable supplement to existing periodontal journals, three monographs are published annually, contributing specialized insights to the field.
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