Department of Oral and Maxillofacial Surgery, University Hospital Carl Gustav Carus, Technical University Dresden, Fetscherstraße 74, Dresden D-01307, Germany.
Ann Anat. 2012 Nov;194(6):545-8. doi: 10.1016/j.aanat.2012.06.002. Epub 2012 Jun 23.
Alveolar bone grafting is an integral part of the treatment concept in cleft palate patients. As an alternative to autogenous bone, tissue-engineered grafts have found some clinical application. The aim of the present study has been to compare ossification in the cleft area using tissue-engineered grafts in a case series of patients with ossification after transplantation of autogenous spongious bone as the gold standard in alveoloplasty. Eight children with complete cleft lips and cleft palates were included in the study. In four children (group A), the cleft defect was filled with tissue-engineered bone (autogenous osteoblasts cultured on demineralized bone matrix Osteovit(®)); as control in another 4 children (group B), the alveoloplasty was performed using spongious iliac bone. Preoperative and 6 months postoperative cone-beam computed tomography was performed, and volumes of the remaining cleft defects were calculated using 3D navigation software. Wound healing was uneventful in both groups. Six months postoperatively the mean volume of the cleft was 0.55±0.24cm(3) after grafting of tissue-engineered bone (group A) and 0.59±0.23cm(3) after transplantation of autogenous spongiosa. In group A, 40.9% of the cleft defect was ossified; in the control group (group B), 36.6%. Tissue-engineered bone is a promising alternative in alveolar bone grafting and no disadvantages were observed in comparison to the gold standard.
牙槽骨移植是腭裂患者治疗方案的重要组成部分。作为自体骨的替代物,组织工程化移植物已经在一些临床应用中得到了应用。本研究的目的是通过与自体松质骨移植作为牙槽成形术的金标准相比,比较在一组接受自体骨移植后骨化的患者中使用组织工程化移植物在裂隙区骨化的情况。本研究纳入了 8 名完全性唇腭裂患儿。在 4 名患儿(A 组)中,用组织工程化骨(自体成骨细胞在脱矿骨基质 Osteovit(®)上培养)填充裂隙缺损;在另 4 名患儿(B 组)中作为对照,用髂骨松质骨进行牙槽成形术。术前和术后 6 个月进行锥形束 CT 检查,并使用 3D 导航软件计算剩余裂隙缺损的体积。两组患儿的伤口愈合均顺利。术后 6 个月,组织工程化骨移植组(A 组)的裂隙平均体积为 0.55±0.24cm³,自体松质骨移植组(B 组)为 0.59±0.23cm³。在 A 组中,40.9%的裂隙缺损骨化;在对照组(B 组)中为 36.6%。与金标准相比,组织工程化骨是一种很有前途的牙槽骨移植替代物,没有观察到任何缺点。