Article record

前庭窝洞疗法的临床与美学结局：系统评价与荟萃分析

Clinical and Esthetic Outcomes of Vestibular Socket Therapy: A Systematic Review and Meta-Analysis.

综述 Meta鼻科IF 3.5Q1

文献信息

PMID	42782925
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Yasser Sherif Soliman 查看其他 5 位作者 Nadine Gräfin von Krockow；Fatma E A Hassanein；Mihad Ibrahim；Abdelsalam ElAskary；Hossam Ismail
作者单位	Oral and Maxillofacial Prosthodontics Department, Goethe University, 60323 Frankfurt, Germany. 查看其他 7 条单位信息 Oral and Maxillofacial Prosthodontics Department, Ain Shams University, Cairo 11566, Egypt.；Department of Postgraduate Education, Goethe University, 60323 Frankfurt, Germany.；Oral Medicine, Periodontology and Oral Diagnosis, Faculty of Dentistry, King Salman International University, El-Tur 46612, Egypt.；Department of Periodontology, Faculty of Dentistry, Cairo University, Cairo 11553, Egypt.；ElAskary and Associates, Alexandria 21500, Egypt.；School of Dentistry, New York University, New York, NY 10012, USA.；School of Dentistry, University of Western Australia, Perth, WA 6009, Australia.
期刊	Dentistry journal
SCI 分区	Q1
IF	3.5
研究类型	综述 Meta · 临床
所属专科	鼻科

中文摘要

背景/目的： 前庭窝洞疗法（VST）是一种用于在受损拔牙窝中即刻种植（IIP）的微创技术，可重建缺损的颊侧骨板，同时保留牙槽嵴软组织。尽管临床采用日益增多，但关于其可预测性和生物学性能的随机证据仍然有限。方法：遵循PRISMA 2020并在PROSPERO前瞻性注册（CRD420261288724），检索PubMed/MEDLINE和EMBASE至2026年1月，纳入评估VST联合IIP的随机对照试验（RCT）。评估偏倚风险（RoB 2）和证据确定性（GRADE）。采用随机效应模型合并最终随访时的颊侧骨板厚度；比较VST内部变异的试验以叙述性方式报告，但不进行合并。结果：共纳入7项RCT（186名参与者）；种植体存活率为99.5%，无屏障暴露、种植体周围炎或裂开。对三项比较VST与另一种不同替代技术的试验进行荟萃分析，显示在任何水平上最终颊侧骨板厚度均无显著组间差异：嵴顶+0.24 mm（95% CI -0.13至0.61；I2 = 45%）、根中+0.32 mm（-0.45至1.09；I2 = 82%）或根尖+0.19 mm（-0.48至0.87；I2 = 67%）。VST显示中面部退缩极小、龈乳头稳定，粉色美学评分为10.29-13.17。所有结局的证据确定性均极低。结论：VST实现了高种植体存活率以及良好的软组织和美学结局，但在颊侧骨板厚度方面并未显著优于对照技术，且证据确定性极低。需要足够把握度、独立且随访时间更长的试验。

英文摘要

Background/Objectives: Vestibular socket therapy (VST) is a minimally invasive technique for immediate implant placement (IIP) in compromised extraction sockets that reconstructs the deficient buccal plate while preserving the crestal soft tissue. Despite growing clinical adoption, the randomized evidence on its predictability and biological performance remains limited. Methods: Following PRISMA 2020 and prospectively registered in PROSPERO (CRD420261288724), PubMed/MEDLINE and EMBASE were searched to January 2026 for randomized controlled trials (RCTs) evaluating VST with IIP. Risk of bias (RoB 2) and certainty of evidence (GRADE) were assessed. Final follow-up buccal bone plate thickness was pooled using a random-effects model; trials comparing variations within VST were reported narratively but not pooled. Results: Seven RCTs (186 participants) were included; implant survival was 99.5%, with no shield exposure, peri-implantitis, or dehiscence. Meta-analysis of the three trials comparing VST against a distinct alternative technique showed no significant between-group difference in final buccal bone plate thickness at any level: crestal +0.24 mm (95% CI-0.13 to 0.61; I2 = 45%), mid-root +0.32 mm (-0.45 to 1.09; I2 = 82%), or apical +0.19 mm (-0.48 to 0.87; I2 = 67%). VST showed minimal mid-facial recession, stable papillae, and Pink Esthetic Scores of 10.29-13.17. Certainty was very low for all outcomes. Conclusions: VST achieved high implant survival and favorable soft tissue and esthetic outcomes but did not significantly outperform comparator techniques in buccal bone plate thickness, with very low certainty. Adequately powered, independent trials with longer follow-up are needed.