【作者】 吴迪；

【导师】 代炜；

【作者基本信息】 中国医科大学 ， 口腔颌面外科学（专业学位）， 2024， 硕士

【摘要】 目的:聚醚醚酮与钛是目前颅颌面骨缺损重建的常用异体材料,这两种材料均具有生物相容性强,可塑性好等优良特性。但对于应用于颅颌面骨缺损重建中那种材料更具优势,却没有定论。方法:根据PRISMA方案和Cochrane系统评价手册的标准进行meta分析,我们通过检索Pub Med、Embase、Cochrane Library、中国知网(CNKI)、万方数据库查找所需文献,文献截止于2023年12月31日,筛选出包含有聚醚醚酮与钛植入物在颅颌面骨重建术后效果的文献,比较术后总并发症发生率、失败率、患者满意度、术后感染率植入物暴露率之间的差异。结果:18篇文献其中PEEK修复颅颌面骨缺损共计736例,Ti植入物修复颅颌面骨缺损共计1336例。17篇文献记录了移植物植入术后总体并发症发生率,术后总并发症发生率OR值为0.947(95%CI:0.762-1.176,P=0.620)。8篇记录了PEEK与Ti植入物重建颅颌面骨缺损术后失败率失败率对比OR值为0.576(95%CI:0.300-1.105,P=0.097),有9篇记录了患者对植入材料的满意度,满意率比较OR值为1.193(95%CI:0.951-1.501,P=0.126),15篇文献记录了植入物术后感染率,OR值为1.413(95%CI:0.901-2.216,P=0.132),差异均不具有统计学意义。12篇文献记录了PEEK与Ti植入物在颅颌面骨重建术后植入物暴露率,结果显示二者OR值为0.279(95%CI:0.129-0.606,P=0.001),P<0.05,差异具有显著性统计学意义,对于植入物暴露率方面,PEEK植入物暴露率显著性降低。对于PEEK植入物在颌骨应力区域重建相关文献查询,发现均取得了良好的重建效果,但由于缺乏PEEK与Ti植入物在颌骨应力区域效果的比较,因此无法纳入meta分析。结论:我们的meta分析结果显示,聚醚醚酮植入物在颅颌面骨重建效果相较于钛在总并发症发生率、失败率、患者满意度以及术后感染率无显著统计学差异,而术后植入物暴露率显著性降低。更多还原

【Abstract】 Objective: Polyether-ether-ketone and titanium are commonly used allogeneic materials for craniofacial bone defect reconstruction,both of which have excellent properties such as strong biocompatibility and good plasticity.However,there is no consensus on which material is more advantageous for the reconstruction of craniofacial bone defects.Methods: According to the PRISMA protocol and the standards of the Cochrane system evaluation manual,we conducted a meta-analysis by searching Pub Med,Embase,Cochrane Library,China National Knowledge Infrastructure(CNKI),and Wanfang database for the required literature.As of December 31,2023,we selected literature that included the postoperative effects of polyether ether ketone and titanium implants,Compare the differences between the overall incidence of postoperative complications,failure rate,patient satisfaction,postoperative infection rate,and implant exposure rate.Results: Among the 18 literatures,736 cases were repaired with PEEK and 1336 cases were repaired with TI implants.The overall postoperative complication rate was recorded in 17 articles,with an OR of 0.947(95%CI:0.762-1.176,P=0.620),P & GT;0.05.The odds ratio(OR)was 0.576(95% CI: 0.300-1.105,P = 0.097),P & GT,the odds ratio for the satisfaction comparison was 1.193(95% CI: 0.951.1.501,P = 0.126),P & GT;0.05,15 articles documented postoperative infection after implants,OR 1.413(95% CI:0.901-2.216,P = 0.132),P & GT;0.05,the differences were not statistically significant.The exposure rate of PEEK and TI implants after craniofacial reconstruction was recorded in 12 literatures.The results showed that the OR of PEEK and TI implants was0.279(95% CI: 0.129-0.606,P = 0.001),and P & Lt;0.05,respectively,the exposure rate of PEEK implants was significantly decreased.Conclusion: The results of our meta-analysis showed that compared with titanium,there was no statistically significant difference in the overall complication rate,failure rate,patient satisfaction rate and postoperative infection rate for craniomaxillofacial bone reconstruction,while postoperative implant exposure rate was significantly reduced.更多还原