背景:牙齿自体移植(DAT)是一种替代患者缺失或受损牙齿的生物学方法。这些技术通常需要多学科的方法。手术的预后和成功可能受到不同因素的不同程度影响。
目的:评估DAT的结果和并发症,包括使用伞式综述的预后因素。
方法:搜索了截至2022年6月30日发表的所有相关系统综述的六个数据库。语言或出版日期没有限制。
方法:DAT研究的系统评价和荟萃分析。
方法:鉴定,筛选,资格,和使用AMSTAR2工具的质量评估由两名作者(M.C.和S.A.)独立进行.两项研究(20%)得分中等,六项研究(60%)得分较低,两项研究(20%)得分极低。数据使用随机效应荟萃分析进行分析,并进行meta回归以研究开放和封闭顶点对因变量的影响.结果总结为相对风险比。
结果:共有310项研究符合纳入条件,其中20项研究被选择用于全文评估。包括十项系统审查,其中9人进行了荟萃分析。总体研究结果表明,DAT提供了良好的成功率和生存率。Meta回归结果表明,闭合的顶点增加了强直和吸收的比例,在观察期间降低了生存率,但对成功率没有影响。
结论:所有系统综述均存在不同程度的异质性和偏倚。系统评价中包括的供体牙齿样本在形态上也有所不同。
结论:DAT是一种技术敏感的程序,需要多学科团队,警惕病例评估和彻底考虑各自涉及的预后因素。尽管研究中报道了方法学上的局限性,DAT显示出良好的成功率和存活率,具有骨诱导和软组织厚度保存的独特优势,并且应该,因此,被认为是一种可行的治疗方式。强烈建议临床指南和实践的标准化。
背景:CRD42020202484。
BACKGROUND: Dental autotransplantation (DAT) is a biological way of replacing missing or compromised teeth for patients. The techniques often necessitate a multi-disciplinary approach. The prognosis and success of the procedure may be impacted by variable factors in varying degrees.
OBJECTIVE: Evaluating outcomes and complications of DAT, including prognostic factors using an umbrella review.
METHODS: Six databases were searched for all relevant systematic reviews published up to 30 June 2022. No restrictions were applied to language or publication date.
METHODS: Systematic reviews and meta-analyses of DAT studies.
METHODS: Identification, screening, eligibility, and quality assessment using the AMSTAR 2 tool were performed independently by two authors (M.C. and S.A.). Two studies (20%) scored moderate, six studies (60%) scored low, and two studies (20%) scored critically low. Data were analysed using a random effects meta-analysis, and meta-regression was performed to investigate the effect of open and closed apices on the dependent variables. The results were summarised as relative risk ratios.
RESULTS: A total of 310 studies were eligible for inclusion, of which 20 studies were selected for full-text evaluation. Ten systematic reviews were included, 9 of which had a meta-analysis. Overall findings suggest that DAT offers favourable success and survival rates. Meta-regression results indicate that a closed apex increased the proportion of ankylosis and resorption, reduced survival but had no effect on success during the observational period.
CONCLUSIONS: A varying degree of heterogeneity and bias was present in all systematic reviews. The samples of donor teeth included in the systematic reviews also varied morphologically.
CONCLUSIONS: DAT is a technique-sensitive procedure requiring a multidisciplinary team, vigilant case assessment and thorough consideration of the respective prognostic factors involved. Despite methodological limitations reported across studies, DAT shows favourable success and survival rates, with a distinctive advantage of bone induction and soft tissue thickness preservation, and should, therefore, be considered as a viable treatment modality. Standardisation of clinical guidelines and practice are highly recommended.
BACKGROUND: CRD42020202484.