骨窗尺寸对上颌窦底提升术后结果影响的Meta分析  

The Effect of the Bone Window Dimension on the Outcomes of Maxillary Sinus Floor Elevation:Meta-Analysis

作　　者：马楠 牛艳 翟洁梅[1,2] 谢志刚 MA Nan;NIU Yan;ZHAI Jiemei;XIE Zhigang(The Affiliated Stomatology Hospital of Kunming Medical University,Kunming Yunnan 650106;Yunnan Key Laboratory of Stomatology,Kunming Yunnan 650106,China;Dept.of Stomatology,Qujing City Qilin District People’s Hospital,Qujing Yunnan 65500,China)

机构地区：[1]昆明医科大学口腔医院,云南昆明650106 [2]云南省口腔医学重点实验室,云南昆明650106 [3]曲靖市麒麟区人民医院口腔科,云南曲靖655000

出　　处：《昆明医科大学学报》2023年第9期39-48,共10页Journal of Kunming Medical University

基　　金：国家自然科学基金资助项目(40119043);云南省科技厅科技计划基金资助项目(202101AY070001-025)。

摘　　要：目的上颌窦底提升术是增加上颌后牙垂直骨量的有效治疗方式,其成功与窦内新骨的形成密切相关。运用系统评价和Meta分析评估骨窗尺寸与上颌窦底提升术后治疗结果的相关性。方法电子检索Medline、Pubmed、Embase、Cochrane图书馆数据库、中国生物医学文献数据库(CBMdisc)和中国知识基础设施工程(CNKI),手动检索国家医学图书馆(NLM)。检索日期截止至2022年11月。检索要求包括经侧壁开窗式上颌窦底提升术分析骨窗尺寸与术后治疗结果的临床研究和动物研究,临床研究要求至少10例患者和6个月以上的随访期。3名研究者根据严格的纳入和排除标准独立纳入相关文献并提取数据进行偏倚风险评估,采用Revman 5.3软件进行Meta分析。结果经全文阅读后共纳入14篇文章进行系统评价。其中9篇为临床对照研究,6篇评估为低偏倚风险,2篇评估为中等偏倚风险,1篇为高偏倚风险。2种骨窗尺寸均能获得术后理想的上颌窦内骨再生和相似的生物学治疗结果。Meta分析结果显示,新骨矿化率与骨窗尺寸呈负相关性(P<0.01)。新骨形成率和剩余骨移植材料率在小骨窗和大骨窗组差异无统计学意义(P>0.05)。结论上颌窦内新骨矿化率与骨窗尺寸呈负相关,因此,经侧壁开窗式上颌窦底提升术中应尽量保存上颌窦侧壁,减小骨窗的制备,才能更大程度地获得窦内新骨的成熟和矿化。Objective Maxillary sinus floor elevation is an effective way to increase the vertical bone mass of maxillary posterior region,and its success is closely related to the formation of new bone.In this study,a systematic review and meta-analysis was used to evaluate the correlation between bone window dimension and postoperative outcomes after maxillary sinus floor elevation.Methods An electronic search strategy was performed on Medline,Pubmed,Embase,Cochrane Library database,Chinese Biology Medicine disc(CBMdisc),China National Knowledge Infrastructure(CNKI),and National Library of Medicine(NLM)up to November 2022.Clinical and animal studies that analyzed the effect of bone window dimension and postoperative outcomes using lateral window elevation were included.Clinical studies with at least ten patients,and a minimum follow-up period of 6 months were included.According to the inclusion and exclusion criteria,three evaluators independently screened related studies,extracted data,and evaluated risk bias.Meta-analysis was performed by Revman 5.3 software.Results A total of 14 studies were included for the systematic review after the full text reading.6 studies with low risk of bias,2 studies with moderate risk of bias and 1 study with high risk of bias were controlled clinical studies.Both of the two bone window dimensions achieved ideal maxillary sinus bone regeneration and similar biological outcomes.The Meta-analysis results showed that mineralized bone%was negatively correlated with the bone window dimension(P<0.01).There was no significant difference in the new bone%,residual graft material%between the small bone window and the large bone window groups.Conclusion Negative correlation has been observed between the mineralized bone%and the dimension of bone window.Therefore,the lateral wall should be preserved as much as possible during the maxillary sinus floor elevation.Reducing the bone window has a positive effect on the maturity and mineralization of new bone.

关 键 词：上颌窦底提升术 种植体 骨窗尺寸 骨再生 

分 类 号：R783[医药卫生—口腔医学]