Influencia de las perforaciones corticales en regeneración ósea guiada: Revisión de la literatura / The influence of cortical perforations on guided bone regeneration: A literature review

RESUMEN

RESUMEN Objetivo: Evaluar la influencia de las perforaciones corticales en regeneración ósea guiada (ROG) mediante resultados de histomorfometría obtenidos de estudios humanos y animales. Revisión de la literatura actual Se realizó una búsqueda electrónica de estudios en humanos y animales en bases de datos PubMed, Cochrane Library, SciELO y Google Scholar desde 1980 hasta mayo del 2017. Se utilizó la siguiente estrategia de búsqueda ((decortication of bone) OR (bone decortication) OR (alveolar decortication) OR (decortication) OR (decortications) OR (cortical perforation of bone) OR (cortical bone perforation) OR (cortical perforation) OR (cortical perforations) OR (intramarrow penetration) OR (marrow penetration)) AND ((guided bone regeneration) OR (guided bone augmentation) OR (bone augmentation) OR (osseous repair) OR (graft integration)). Discusión y conclusión: Se identificaron 65 artículos y sólo se seleccionaron 8. Cuatro estudios en animales mostraron influencia estadísticamente significativa al realizar perforaciones corticales. En 3 estudios en animales y en un estudio en humanos esta diferencia no fue estadísticamente significativa. Sin embargo, al realizar perforaciones existió mayor número de vasos sanguíneos y mayor formación ósea sin reacciones inflamatorias resaltantes ni impactos negativos. Las perforaciones corticales muestran beneficios en etapas tempranas de cicatrización influyendo significativamente en la angiogénesis incrementando la cantidad de hueso neoformado.

ABSTRACT

ABSTRACT Objective: To evaluate the influence of cortical perforations on guided bone regeneration (ROG) by histomorphometry results obtained from human and animal studies. Review of current literature An electronic search of trials in humans and animals with histomorphometric evaluations was carried out in the PubMed, Cochrane Library, SciELO and Google Scholar databases from 1980 to May 2017. The following search strategy was used ((decortication of bone) OR (bone decortication) OR (alveolar decortication) OR (decortication) OR (decortications) OR (cortical perforation of bone) OR (cortical bone perforation) OR (cortical perforation) OR (cortical perforations) OR (intramarrow penetration) OR (marrow penetration)) AND ((guided bone regeneration) OR (guided bone augmentation) OR (bone augmentation) OR (osseous repair) OR (graft integration)). Discussion and conclusion: Sixty five articles were identified and only 8 were selected. Four studies in animals showed statistically significant influence when performing cortical perforations. In 3 studies in animals and in 1 human study this difference was not statistically significant. However, when drilling, a greater number of blood vessels and a greater bone formation without inflammatory reactions or negative impacts were recorded. Cortical perforations show benefits in early stages of healing, influencing significantly in the angiogenesis, increasing the amount of neoformed bone.