Quality assessment of systematic reviews on vertical bone regeneration

Int J Oral Maxillofac Surg. 2019 Mar;48(3):364-372. doi: 10.1016/j.ijom.2018.07.014. Epub 2018 Aug 21.


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® 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.

Keywords: block graft; bone regeneration; distraction osteogenesis; vertical bone augmentation.

Publication types

  • Review

MeSH terms

  • Alveolar Ridge Augmentation / methods*
  • Bone Regeneration / physiology*
  • Humans
  • Meta-Analysis as Topic*
  • Systematic Reviews as Topic*