可吸收材料内固定与钛合金内固定对正颌术后骨稳定性的Meta分析

摘要

Objective To evaluate the skeletal stability of bioabsorbable fixation and titanium system for or-thognathic surgery. Methods PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL) were searched to collect comparative studies of bioabsorbable fixation versus titanium system for orthognathic surgery, in-cluding controlled clinical trial (CCT), randomized controlled trial (RCT), retrospective study (RS) from 2004 to 2014. After extraction literature data and quality evaluation, RevMan5.3 software was used for system evaluation. The changes of angular and horizontal and vertical liner parameters in BSSRO and Le Fort I surgery were compared be-tween the bioabsorbable fixation group and titanium system group. Results A total of 10 literatures (2 RCTs, 3 RSs, 5 CCTs) were included. There was no significant difference on horizontal and vertical sketletal stability of BSSRO and Le Fort I between the bioabsorbable fixation group and the titanium system group in orthognathic surgery (P>0.05). Conclusion Bioabsorbable fixation and the titanium system result in similar sketletal stability. Because of the small number of the included studies, which weakens the strength of the evidence of our results, there is moderate bias risk in this review. More high-quality and large-sample studies are needed to provide further evidences. The material for fixation should be selected based on indications.%目的 评价可吸收材料内固定与钛合金内固定对正颌术后的骨稳定性.方法 计算机检索2004-2014年PubNed、Cochrane Library、Embase数据库,收集可吸收材料内固定与钛合金内固定在正颌外科应用的各类对照性研究,提取文献数据及质量评价后,用RevMan5.3软件进行系统评价,比较两者在BSSRO和Le Fort I术后水平向和垂直向的骨稳定性.结果 共有10篇文献纳入研究,Meta分析结果显示两者在BSSRO和Le Fort I术后水平向和垂直向有相似的骨稳定性,差异均无统计学意义(P>0.05).结论 可吸收内固定材料与钛合金比较,两者在正颌术后均可提供相似的骨稳定性.由于该系统评价纳入研究的样本量较小,原始研究质量较低,且有中度偏倚风险,需要更多高质量、大样本的随机对照试验提供更可靠的证据,建议临床严格把握适应证,选择合适的内固定材料.