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目的系统评价富血小板血浆联合植骨材料治疗牙周骨内缺损的疗效。方法计算机检索PubMed、e Cochrane Library、EMbase、CNKI、CBM和WanFang Data,查找富血小板血浆(platelet-rich plasma,PRP)联合植骨材料与单用植骨材料比较治疗牙周骨内缺损的随机对照试验(RCT),检索时限均从建库至2012年8月。由2名研究员按照纳入和排除标准筛选文献、提取资料,并评价纳入研究的方法学质量后,采用RevMan 5.2软件进行Meta分析。结果最终纳入11个RCT,共342例受试者。7个研究的合并分析结果显示,PRP联合植骨材料组的临床附着丧失增加程度低于单用植骨材料组[WMD=0.70,95%CI(0.51,0.90),P<0.000 01]。7个研究的合并分析结果显示,两组的牙龈退缩程度差异无统计学意义[WMD=–0.01,95%CI(–0.15,0.13),P=0.86]。9个研究的合并分析结果显示,PRP联合植骨材料组菌斑指数的减少程度与植骨材料组之间差异无统计学意义[WMD=0.04,95%CI(0.09,0.02),P=0.20]。结论在临床附着丧失方面,PRP联合植骨材料组疗效优于单用植骨材料组,然而,在牙龈退缩、菌斑指数方面,两者疗效无差异。受纳入研究数量限制,且测量指标不全面,上述结论尚待开展更多高质量、大样本的研究予以证实。
Objective To evaluate the efficacy of platelet-rich plasma combined with bone graft in the treatment of periodontal bone defect. Methods Randomized controlled clinical trials comparing PubMed, e Cochrane Library, EMbase, CNKI, CBM and WanFang Data were performed to compare platelet-rich plasma (PRP) with bone graft versus bone graft alone Trial (RCT), retrieval time from the database to August 2012. Two researchers screened the literature for inclusion and exclusion criteria, extracted data, and evaluated the quality of the methodology included in the study, using Meta-analysis using RevMan 5.2 software. The results eventually included 11 RCTs, a total of 342 subjects. The pooled analysis of 7 studies showed that the rate of clinical attachment loss in the PRP combined with bone graft material group was lower than that of the bone graft alone group [WMD = 0.70, 95% CI (0.51, 0.90), P <0.000 01]. The combined analysis of 7 studies showed that there was no significant difference in gingival recession between the two groups (WMD = -0.01, 95% CI (-0.15, 0.13), P = 0.86]. The combined analysis of 9 studies showed that there was no significant difference in the reduction of plaque index between the PRP group and the bone graft group [WMD = 0.04,95% CI (0.09,0.02), P = 0.20 ]. Conclusions In clinical attachment loss, PRP combined with bone graft group is superior to single bone graft group. However, there is no difference in gingival recession and plaque index between the two groups. Due to the limited number of studies included, and the lack of comprehensive measures, the above conclusion has yet to be confirmed by more high-quality, large sample studies.