Chinese Journal of Tissue Engineering Research ›› 2026, Vol. 30 ›› Issue (26): 6946-6951.doi: 10.12307/2026.826

Previous Articles     Next Articles

A network meta-analysis of therapeutic effects of different bone repair materials on apical bone defects

Zhang Kaijing, Li Chunnian, Li Yizhuo, Xu Shifang, Liu Xinyue   

  1. School and Hospital of Stomatology, Hebei Medical University & Hebei Key Laboratory of Stomatology, Shijiazhuang 050017, Hebei Province, China
  • Accepted:2025-12-17 Online:2026-09-18 Published:2026-03-16
  • Contact: Li Chunnian, MS, Chief physician, Master’s supervisor, School and Hospital of Stomatology, Hebei Medical University & Hebei Key Laboratory of Stomatology, Shijiazhuang 050017, Hebei Province, China
  • About author:Zhang Kaijing, MS, School and Hospital of Stomatology, Hebei Medical University & Hebei Key Laboratory of Stomatology, Shijiazhuang 050017, Hebei Province, China
  • Supported by:
    Key Research Project of Hebei Provincial Medical Science Project, No. 20241080 (to LCN)

PDF

14

Abstract: OBJECTIVE: To promote the regeneration of apical bone defects, autologous bone, xenograft bone, synthetic bone, and bioactive materials are commonly used clinically. However, a systematic comparison of the efficacy of each repair material is lacking. Therefore, this study used a network meta-analysis to comprehensively compare and evaluate the differences in efficacy of different bone repair materials in treating apical bone defects.
METHODS: Randomized controlled trials on the treatment of apical bone defects caused by chronic periapical periodontitis or apical cysts using bone repair materials were searched in databases including CNKI, WanFang Data, VIP, SinoMed, PubMed, Embase, Web of Science, and Cochrane Library. The search period was from database inception to July 20, 2025. According to the Cochrane Handbook of Evaluation, RevMan 5.4 software was used to assess the risk of bias in the included literature. Stata 17MP was used for statistical analysis.
RESULTS: A total of 21 studies involving 1 286 patients were included, evaluating 10 interventions: hydroxyapatite, deproteinized bovine bone mineralz, collagen membrane, hydroxyapatite + collagen membrane, deproteinized bovine bone mineralz + collagen membrane, concentrated growth factor, platelet-rich fibrin, gelatin sponge, blank control (natural healing of blood clot), and platelet-rich plasma. The network meta-analysis revealed the following rankings: (1) Treatment efficacy (from best to worst): The top three interventions were hydroxyapatite + collagen membrane > deproteinized bovine bone mineralz + collagen membrane > concentrated growth factor. (2) Incidence of adverse reactions (from highest to lowest): Gelatin sponge > blank control > hydroxyapatite > hydroxyapatite + collagen membrane. 
CONCLUSION: For the treatment of apical bone defects, the combination of hydroxyapatite and a collagen membrane demonstrated the most significant therapeutic efficacy and the lowest incidence of postoperative adverse reactions. Due to limitations in the number and quality of the included studies, further more clinical trials are needed to validate these findings.


Key words: network meta-analysis, bone repair materials, periapicalperiodontitis, periapicalcyst, apical bone defects, hydroxylapatite, collagen membrane, efficacy, incidence of adverse reactions

CLC Number: