Journal
INTERNATIONAL JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY
Volume 48, Issue 3, Pages 364-372Publisher
CHURCHILL LIVINGSTONE
DOI: 10.1016/j.ijom.2018.07.014
Keywords
vertical bone augmentation; distraction osteogenesis; bone regeneration; block graft
Categories
Funding
- Evidence Based Dentistry Center, Lisbon University
- Implant Dentistry Department, European University of Madrid
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The aim of this study was to evaluate and compare the quality of systematic reviews of vertical bone regeneration techniques, using two quality-assessment tools (AMSTAR and ROBIS). An electronic literature search was conducted to identify systematic reviews or meta-analyses that would evaluate at least one of the following outcomes: implant survival, success rates, complications or bone gain after vertical ridge augmentation. Methodological quality assessment was performed by two independent evaluators. Results were compared between reviewers, and reliability measures were calculated using the Holsti's method(R) and Cohen's kappa. Seventeen systematic reviews were included, of which seven presented meta-analysis. Mean +/- 95% confidence interval AMSTAR score was 6.35 [4.74;7.97], with higher scores being correlated with a smaller risk of bias (Pearson's correlation coefficient = -0.84; P < 0.01). Cohen's inter-examiner kappa showed substantial agreement for both checklists. From the available evidence, we ascertained that, regardless of the technique used, it is possible to obtain vertical bone gains. Implant success in regenerated areas was similar to implants placed in pristine bone with results equating between 61.5% and 100% with guided bone regeneration being considered the most predictable technique regarding bone stability, while distraction osteogenesis achieved the biggest bone gains with the highest risk of possible complications.
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