ABSTRACT
BACKGROUND:Absorbable colagen membrane can be theoreticaly applied to secondary alveolar bone grafting in alveolar cleft surgery, which can improve the bone preservation and slow bone resorption. However, there is stil no unified conclusion. OBJECTIVE:To assess the efficacy and safety of absorbable colagen membrane for secondary alveolar bone grafting viaa systematic review. METHODS:MEDLINE, EMBASE, CBM and CAJD were searched for eligible articles addressing clinical randomized controled or controled trials of absorbable colagen membrane for secondary alveolar bone grafting. Test group received bone grafting with absorbable colagen membrane and control group only received bone grafting. Meta-analysis on the clinical success rate of bone grafting and incidence of complications in the recipient region was delivered with Revman 5.3. RESULTS AND CONCLUSION:Five clinical trials, involving 416 cleft sites and 387 participants, were included. Two had high risk of bias and the rest had unclear risk of bias. If “the height of new bone is≥ 50% of alveolar height” was adopted as clinical success, the clinical success rate of the test group was significantly higher than that of the control group (P=0.002, relative risk value=1.33, 95% confidence interval [1.11, 1.60]). If “the height of new bone is≥ 75% of alveolar height” was chosen as clinical success, the clinical success rate of the test group was higher than that of the control group, but there was no significant difference between the two groups (P=0.06, relative risk value=1.40, 95% confidence interval [0.99, 1.99]). For safety, the use of absorbable colagen membrane could not increase the complications incidence (P=0.35, relative risk value=0.66, 95% confidence interval [0.28, 1.58]). So, the use of absorbable colagen membrane is safe to improve the clinical success rate of secondary alveolar bone grafting in alveolar cleft surgery. More randomized controled trials should be considered to reinforce the conclusion.
ABSTRACT
BACKGROUND:There are numerous clinical studies on comparing absorbable internal fixation system and titanium metal internal fixation system in maxilofacial fractures; however, the systematic reviews and Meta-analysis in this field are rare. OBJECTIVE:To compare the clinical effect of absorbable internal fixation system and titanium internal fixation system in maxilofacial fractures through systematic review and Meta-analysis. MATERIALS AND METHODS:The randomized controled trials and controled clinical trials regarding the application of absorbable internal fixation system and titanium internal fixation system in maxilofacial fractures were electronicaly retrieved from Medline, Embase, the Cochrane Central Register of Controled Trials, China Biology Medicine disc, and China Academic Journal Network Publishing Database using the keywords. Meta-analysis was conducted using Revman 5.3 software. RESULTS AND CONCLUSION:Thirteen clinical studies were included, and totaly 1 718 patients were involved. The Meta-analysis results showed that the removal rate of implants in the absorbable internal fixation system group was significantly lower than that in the titanium internal fixation group (P=0.000 2); there were no significant differences in the healing rate of fracture I stage, the incidence of insufficient fixation in fracture site and the incidence of long-term complications between these two groups. These results demonstrate that the efficiency and safety of absorbable internal fixation system in maxillofacial fracture is satisfactory, and can reduce the proportion of secondary surgical removal of the implant. More randomized controlled trials should be conducted to confirm this conclusion.