{"title":"同种异体材料、生物制剂及其组合以及缺陷特征对短期骨内缺陷手术治疗结果的影响：系统综述和网络荟萃分析","authors":"Khanti Rattanpornsompong, Kantapon Rattanaprukskul, Sikharate Prachanukoon, Kanokrat Sriwangyang, Mawika Rinkrathok, Junji Tagami, Thantrira Porntaveetus","doi":"10.1186/s12903-025-05782-0","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Treating periodontal intrabony defects remains challenging, alloplast materials and biologics are increasingly utilized to improve regeneration outcomes. However, comparative efficacy on alloplast materials remains limited. This study aimed to evaluate the effectiveness of alloplastic materials, both alone and combined with biologics, in treating periodontal defects.</p><p><strong>Methods: </strong>A systematic search of PubMed, Scopus, and CENTRAL identified 74 eligible randomized controlled trials. Meta-analysis assessed data heterogeneity based on defect depth and morphology, classifying defects by wall configuration. Network meta-analysis compared clinical attachment level (CAL) gain, probing depth (PD) reduction, and radiographic linear bone (RLB) gain up to 12 months. Risk of bias was evaluated using the Cochrane Risk of Bias 2 tool, and confidence in network meta-analysis was graded using CINeMA.</p><p><strong>Results: </strong>Defect depth and morphology significantly impacted heterogeneity outcomes at 6 months, but by 12 months, differences across treatments were less significant. Biphasic calcium phosphate (BCP) and nanocrystalline hydroxyapatite (nHA) showed notable improvements in CAL gain, PD reduction, and RLB gain. Combining nHA with platelet-rich fibrin (PRF) outperformed open flap debridement (mean differences at 6 months for CAL gain: 1.37 mm, PD reduction: 1.52 mm and RLB gain: 1.39 mm). SUCRA ranked bioglass and BCP highest for single treatments, while bioglass with platelet-rich plasma and nHA + PRF excelled among combinations.</p><p><strong>Conclusions: </strong>Alloplastic materials, particularly BCP and nHA, significantly enhance periodontal treatment outcomes, especially when combined with biologics like PRF. Defect depth and morphology influence treatment efficacy at 6 months, though by 12 months, treatment outcomes converge, underscoring the value of early, tailored strategies in periodontal therapy.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":9072,"journal":{"name":"BMC Oral Health","volume":"25 1","pages":"413"},"PeriodicalIF":2.6000,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927257/pdf/","citationCount":"0","resultStr":"{\"title\":\"Influence of alloplastic materials, biologics, and their combinations, along with defect characteristics, on short-term intrabony defect surgical treatment outcomes: a systematic review and network meta-analysis.\",\"authors\":\"Khanti Rattanpornsompong, Kantapon Rattanaprukskul, Sikharate Prachanukoon, Kanokrat Sriwangyang, Mawika Rinkrathok, Junji Tagami, Thantrira Porntaveetus\",\"doi\":\"10.1186/s12903-025-05782-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Treating periodontal intrabony defects remains challenging, alloplast materials and biologics are increasingly utilized to improve regeneration outcomes. However, comparative efficacy on alloplast materials remains limited. This study aimed to evaluate the effectiveness of alloplastic materials, both alone and combined with biologics, in treating periodontal defects.</p><p><strong>Methods: </strong>A systematic search of PubMed, Scopus, and CENTRAL identified 74 eligible randomized controlled trials. Meta-analysis assessed data heterogeneity based on defect depth and morphology, classifying defects by wall configuration. Network meta-analysis compared clinical attachment level (CAL) gain, probing depth (PD) reduction, and radiographic linear bone (RLB) gain up to 12 months. Risk of bias was evaluated using the Cochrane Risk of Bias 2 tool, and confidence in network meta-analysis was graded using CINeMA.</p><p><strong>Results: </strong>Defect depth and morphology significantly impacted heterogeneity outcomes at 6 months, but by 12 months, differences across treatments were less significant. Biphasic calcium phosphate (BCP) and nanocrystalline hydroxyapatite (nHA) showed notable improvements in CAL gain, PD reduction, and RLB gain. Combining nHA with platelet-rich fibrin (PRF) outperformed open flap debridement (mean differences at 6 months for CAL gain: 1.37 mm, PD reduction: 1.52 mm and RLB gain: 1.39 mm). SUCRA ranked bioglass and BCP highest for single treatments, while bioglass with platelet-rich plasma and nHA + PRF excelled among combinations.</p><p><strong>Conclusions: </strong>Alloplastic materials, particularly BCP and nHA, significantly enhance periodontal treatment outcomes, especially when combined with biologics like PRF. Defect depth and morphology influence treatment efficacy at 6 months, though by 12 months, treatment outcomes converge, underscoring the value of early, tailored strategies in periodontal therapy.</p><p><strong>Trial registration: </strong>Not applicable.</p>\",\"PeriodicalId\":9072,\"journal\":{\"name\":\"BMC Oral Health\",\"volume\":\"25 1\",\"pages\":\"413\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-03-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927257/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMC Oral Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12903-025-05782-0\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"DENTISTRY, ORAL SURGERY & MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Oral Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12903-025-05782-0","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
Influence of alloplastic materials, biologics, and their combinations, along with defect characteristics, on short-term intrabony defect surgical treatment outcomes: a systematic review and network meta-analysis.
Background: Treating periodontal intrabony defects remains challenging, alloplast materials and biologics are increasingly utilized to improve regeneration outcomes. However, comparative efficacy on alloplast materials remains limited. This study aimed to evaluate the effectiveness of alloplastic materials, both alone and combined with biologics, in treating periodontal defects.
Methods: A systematic search of PubMed, Scopus, and CENTRAL identified 74 eligible randomized controlled trials. Meta-analysis assessed data heterogeneity based on defect depth and morphology, classifying defects by wall configuration. Network meta-analysis compared clinical attachment level (CAL) gain, probing depth (PD) reduction, and radiographic linear bone (RLB) gain up to 12 months. Risk of bias was evaluated using the Cochrane Risk of Bias 2 tool, and confidence in network meta-analysis was graded using CINeMA.
Results: Defect depth and morphology significantly impacted heterogeneity outcomes at 6 months, but by 12 months, differences across treatments were less significant. Biphasic calcium phosphate (BCP) and nanocrystalline hydroxyapatite (nHA) showed notable improvements in CAL gain, PD reduction, and RLB gain. Combining nHA with platelet-rich fibrin (PRF) outperformed open flap debridement (mean differences at 6 months for CAL gain: 1.37 mm, PD reduction: 1.52 mm and RLB gain: 1.39 mm). SUCRA ranked bioglass and BCP highest for single treatments, while bioglass with platelet-rich plasma and nHA + PRF excelled among combinations.
Conclusions: Alloplastic materials, particularly BCP and nHA, significantly enhance periodontal treatment outcomes, especially when combined with biologics like PRF. Defect depth and morphology influence treatment efficacy at 6 months, though by 12 months, treatment outcomes converge, underscoring the value of early, tailored strategies in periodontal therapy.
期刊介绍：
BMC Oral Health is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of disorders of the mouth, teeth and gums, as well as related molecular genetics, pathophysiology, and epidemiology.
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