可吸收生物聚合物在口腔外科中的有效性和并发症发生率:系统综述。

IF 2.5 Q2 DENTISTRY, ORAL SURGERY & MEDICINE
Riccardo Fabozzi, Francesco Bianchetti, Domenico Baldi, Catherine Yumang Sanchez, Francesco Bagnasco, Nicola De Angelis
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引用次数: 0

摘要

背景:可吸收生物聚合物被越来越多地用于牙科外科再生手术。它们的自然降解能力,最大限度地减少手术再干预,并潜在地降低免疫原性,使它们在引导骨和组织再生应用中具有吸引力。然而,尽管有这些优点,它们的相对有效性和相关风险仍然存在不确定性。例如,在骨再生过程中,聚乙二醇(PEG)基膜显示出与猪源胶原膜相当的结果,但研究报告PEG基材料相关的软组织愈合并发症发生率更高。同样,尽管聚己内酯(PCL)和糊精基水凝胶已经显示出了良好的临床处理和骨填充能力,但它们在不同解剖部位的长期性能和一致性仍有待研究。这些发现突出表明,需要进一步开展有力的临床试验,为其安全和有效的使用建立标准化的指导方针。方法:系统评价方案在PROSPERO数据库注册,并根据PRISMA指南制定。数据库检索于2024年6月至12月在PubMed、Medline、Scopus和Cochrane进行。仅随机对照试验(rct)关注合成可吸收生物聚合物在骨增强手术中被考虑。使用Cochrane偏倚风险工具评估偏倚。结果:纳入11项随机对照试验,共188例患者。研究结果表明,聚乳酸(PLA)、聚己内酯(PCL)和聚乙二醇(PEG)等材料有助于新骨的形成。聚乙二醇基膜的性能与传统的猪源胶原膜相当,有时甚至更好。此外,3d打印聚合物在特定部位愈合方面的应用也显示出了前景。结论:可吸收生物聚合物在GBR手术中是有效和安全的,其临床结果与传统材料相当。3d打印技术和生物活性涂层的进步可能会进一步增强它们的再生潜力。然而,软组织愈合并发症的发生率表明需要进一步的长期研究来优化材料的性能和临床应用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Effectiveness and Complication Rate of Resorbable Biopolymers in Oral Surgery: A Systematic Review.

Background: Resorbable biopolymers are increasingly explored for use in regenerative procedures within dental surgery. Their ability to degrade naturally, minimize surgical reinterventions, and potentially reduce immunogenicity makes them appealing in guided bone and tissue regeneration applications. However, despite these advantages, uncertainties persist regarding their comparative effectiveness and associated risks. For example, polyethylene glycol (PEG)-based membranes have shown comparable outcomes to porcine-derived collagen membranes in bone regeneration procedures, yet studies have reported a higher incidence of soft tissue healing complications associated with PEG-based materials. Similarly, while polycaprolactone (PCL) and dextrin-based hydrogels have demonstrated promising clinical handling and bone fill capabilities, their long-term performance and consistency across different anatomical sites remain under investigation. These findings highlight the need for further well-powered clinical trials to establish standardized guidelines for their safe and effective use. Methods: A systematic review protocol was registered with the PROSPERO database and developed in alignment with PRISMA guidelines. Database searches were conducted in PubMed, Medline, Scopus, and Cochrane from June to December 2024. Only randomized controlled trials (RCTs) focusing on synthetic resorbable biopolymers in bone augmentation procedures were considered. Bias was evaluated using the Cochrane Risk of Bias tool. Results: Eleven RCTs were included, totaling 188 patients. The findings suggest that materials such as polylactic acid (PLA), polycaprolactone (PCL), and polyethylene glycol (PEG) contributed effectively to new bone formation. PEG-based membranes were found to perform on par with or occasionally better than traditional collagen membranes derived from porcine sources. Additionally, the application of 3D-printable polymers demonstrated promise in site-specific healing. Conclusions: Resorbable biopolymers are effective and safe for GBR procedures, with clinical outcomes comparable to traditional materials. Advances in 3D-printing technology and bioactive coatings may further enhance their regenerative potential. However, the incidence of soft tissue healing complications suggests the need for further long-term studies to optimize material properties and clinical application.

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来源期刊
Dentistry Journal
Dentistry Journal Dentistry-Dentistry (all)
CiteScore
3.70
自引率
7.70%
发文量
213
审稿时长
11 weeks
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