目的:本综述旨在全面分析拔牙后牙槽窝愈合的现有证据,包括i)肺泡窝愈合过程中的组织学和分子事件,ii)窝愈合后的尺寸脊改变和与窦气化有关的争议,iii)患者特定因素,程序要素,以及影响套接字愈合的站点相关变量,iv)牙槽脊保存(ARP)程序的技术和有效性,和v)ARP在临床实践中的理念和成本效益。
■为了研究无辅助愈合后牙槽脊的尺寸轮廓,2024年2月,两名独立审评员对系统审评进行了概述.在Pubmed中搜索了四个电子数据库,Embase,2004年至2024年之间的WebofScience和CochraneLibrary,以确定有关摘除后愈合的所有相关系统评价。还进行了进一步的人工审查。全文进一步审查了这些文章的相关性。采用AMSTAR-2评估工具来评估方法质量。在叙述中客观地分析了与其他列出的目标有关的当前研究。
方法:在459项检索到的研究中选择了11项,并最终在本综述中涵盖了自然愈合后牙槽嵴的尺寸变化:三项系统评价和四项系统评价与荟萃分析。所有纳入审查的方法质量都极低。
结论:这篇综述彻底检查了拔牙后肺泡窝的愈合情况,并强调了具有重叠阶段的动态过程以及结局的个体间差异。牙槽脊保存(ARP)程序是促进假体部位发育的潜在策略,目前的证据是有限的。在这里,个性化和假肢驱动的方法至关重要。需要对新型生物材料进行进一步的规模和设计试验,可以探索人工智能在预测愈合和辅助临床决策中的作用。(293字)临床意义:通过提高我们对牙槽窝愈合及其管理策略的理解,临床医生可以就患者和站点级别的评估和选择做出更明智的决定,外科技术,和生物材料的选择,最终有助于增强愈合过程,减少并发症,提高接受拔牙和种植牙治疗的患者的生活质量。
This review was to offer a comprehensive analysis of currently available evidence on post-extraction alveolar socket healing, including i) the histological and molecular events during alveolar socket healing, ii) the dimensional ridge alterations after socket healing and controversies relating to sinus pneumatisation, iii) the patient-specific factors, procedural elements, and site-related variables influencing socket healing, iv) techniques and effectiveness of alveolar ridge preservation (ARP) procedure, and v) the philosophies and cost-effectiveness of ARP in clinical practice.
To investigate the dimensional profiles of the alveolar ridge following unassisted healing, an overview of systematic reviews was conducted in February 2024 by two independent reviewers. Four electronic databases were searched in Pubmed, Embase, Web of science and Cochrane Library between 2004 and 2024 to identify all relevant systematic reviews on post-extraction healing. A further manual search of reviews was also conducted. The articles were further reviewed in full text for relevance. The AMSTAR-2 appraisal tool was adopted to assess methodological quality. Current research pertaining to other listed objectives was objectively analysed in narration.
11 out of 459 retrieved studies were selected and ultimately covered in this review on the dimensional changes of alveolar ridge following natural healing: Seven systematic reviews and four systematic reviews with meta-analyses. The methodological quality of all included reviews was critically low.
This review thoroughly examines the healing profiles of post-extraction alveolar sockets and highlights the dynamic process with overlapping phases and the inter-individual variability in outcomes. ARP procedure is a potential strategy for facilitating prosthetic site development, while the current evidence is limited. Herein, an individualised and prosthetically driven approach is crucial. Further well sized and designed trials with novel biomaterials need to be undertaken, and the role of artificial intelligence in predicting healing and assisting clinical decision-making could be explored.
By advancing our understanding of alveolar socket healing and its management strategies, clinicians can make more informed decisions regarding patient and site level assessment and selection, surgical techniques, and biomaterial choices, ultimately contributing to the enhanced healing process with reduced complications and improved quality of life for patients undergoing tooth extraction and dental implant treatments.