Horch H-H, Sader R, Pautke C, Neff A, Deppe H, Kolk A
Department of Oral and Cranio-Maxillofacial Surgery, Technical University of Munich, Klinikum rechts der Isar, Ismaninger Strasse 22, D-81675 Munich, Germany.
Int J Oral Maxillofac Surg. 2006 Aug;35(8):708-13. doi: 10.1016/j.ijom.2006.03.017. Epub 2006 May 9.
The aim of this study was to investigate the long-term effect of the ceramic beta-tricalcium phosphate (beta-TCP) at different sites of alveolar reconstruction and to evaluate its properties. From 1997 to 2002, beta-TCP was implanted as bone substitute in 152 patients using a standardized study protocol. Main indications were the filling of large mandibular cysts (n=52), secondary and tertiary alveolar cleft grafting (n=38), periodontal defects (n=24) and maxillary sinus floor augmentation (n=16). For defects exceeding 2cm in diameter, beta-TCP was combined with autologous bone taken from the retromolar area, the maxillary tuberosity or the chin region. A radiological, clinical and ultrasonographical examination was carried out 4, 12 and 52 weeks postoperative. In 16 cases, biopsies were taken after 12 months indicating complete bony regeneration. While wound-healing disturbances occurred in 9.2% of cases, partial loss of the bone substitute material was found in 5.9%, while total loss occurred in only 2%. Complete radiological replacement of beta-TCP by autologous bone was found after approximately 12 months, indicating its osteoconductive properties. Because of its versatility, low complication rate and good long-term results, synthetic, pure-phase beta-TCP is a suitable material for the filling of bone defects in the alveolar region.
本研究的目的是调查陶瓷β-磷酸三钙(β-TCP)在牙槽骨重建不同部位的长期效果,并评估其性能。1997年至2002年期间,采用标准化研究方案,将β-TCP作为骨替代物植入152例患者体内。主要适应证包括填充大型下颌囊肿(n = 52)、二期和三期牙槽嵴裂植骨(n = 38)、牙周缺损(n = 24)和上颌窦底提升(n = 16)。对于直径超过2cm的缺损,β-TCP与取自磨牙后区、上颌结节或颏部区域的自体骨联合使用。术后4周、12周和52周进行了放射学、临床和超声检查。16例患者在12个月后进行了活检,结果显示骨完全再生。9.2%的病例出现了伤口愈合障碍,5.9%的病例发现骨替代材料部分丢失,而完全丢失仅占2%。大约12个月后发现β-TCP被自体骨完全放射学替代,表明其具有骨传导性能。由于其多功能性、低并发症发生率和良好的长期效果,合成的纯相β-TCP是填充牙槽骨区域骨缺损的合适材料。