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上颌骨囊性缺损植骨后愈合的观察策略及影像学分类:一项放射学评估

Observer strategy and radiographic classification of healing after grafting of cystic defects in maxilla: a radiological appraisal.

作者信息

Kattimani Vivekanand S, Bajantai Nivedita V, Sriram Sanjay Krishna, Sriram Roopa Rani, Rao V K Prabhakar, Desai Priti D

机构信息

Department of Oral and Maxillofacial Surgery, SD Dental College and Hospital, Parbhani, Maharashtra, India.

出版信息

J Contemp Dent Pract. 2013 Mar 1;14(2):227-32. doi: 10.5005/jp-journals-10024-1304.

Abstract

AIM

The aim is to radiographically quantify the bone density and relate the same with observer strategy in the bone healing.

OBJECTIVES

To assess pattern of bone regeneration following grafting of defects with hydroxyapatite after apicoectomy/cystic enucleation.

MATERIALS AND METHODS

An observer strategy involving trained and experienced examiners used in large series of cases, evaluated radiographically over a period of 1 year with intervals. The cases were grouped into different categories depending on (1) surgical site outline merging with material margin, (2) internal portion of surgical site (i.e. bone formation characteristics) and (3) density of surgical site. The radiographs examined by blind process and the findings were tabulated. Operating surgeon (oral surgeon) has done the interpretation of data to create observer strategy of grafting cases.

OBSERVATIONS AND RESULTS

The outline of the defect was changed, partly reduced and completely absent along with remodeling, which showed ground glass, specular or trabecular pattern of bone over a time with increasing density correlating bone regeneration within a short duration. The applied strategy and classification are recommended for follow-up studies. In this study the characteristics of the new bone formation were also delineated. This strategy is helpful for follow-up studies; implant procedures and so; to know quality and condition of bone after treatment.

摘要

目的

通过影像学方法对骨密度进行量化,并将其与骨愈合过程中的观察者策略相关联。

目标

评估根尖切除/囊肿摘除术后用羟基磷灰石植入缺损部位后的骨再生模式。

材料与方法

采用一种观察者策略,由经过培训且经验丰富的检查人员对大量病例进行评估,在1年的时间里定期进行影像学检查。根据以下几点将病例分为不同类别:(1)手术部位轮廓与材料边缘的融合情况;(2)手术部位内部情况(即骨形成特征);(3)手术部位的密度。通过盲法检查X光片,并将结果列表。手术医生(口腔外科医生)对数据进行解读,以制定植骨病例的观察者策略。

观察结果

随着重塑过程,缺损部位的轮廓发生改变,部分缩小,直至完全消失,同时呈现出磨砂玻璃样、镜面样或小梁样骨,随着时间推移密度增加,这表明在短时间内骨再生情况良好。建议将所应用的策略和分类方法用于后续研究。在本研究中,还明确了新骨形成的特征。该策略有助于后续研究、植入手术等,以便了解治疗后骨的质量和状况。

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