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[基于非脱矿骨胶原和人工羟基磷灰石的骨成型材料在口腔外科门诊手术中闭合骨缺损的对比分析及临床经验]

[Comparative analysis and clinical experience with osteoplastic materials materials based on non-demineralized bone collagen and artificial hydroxylapatite at the close of bone defects in ambulatory surgical dentistry].

作者信息

Dunaev M V, Kitaev V A, Matavkina M V, Druzhinin A E, Bubnov A S

出版信息

Vestn Ross Akad Med Nauk. 2014(7-8):112-20. doi: 10.15690/vramn.v69i7-8.1117.

Abstract

BACKGROUND

In the presence of bone defects during surgery is not always performed osteoptastic material replenishment defect that leads to a lengthening of the timing healing, bone regeneration, and treatment outcome. Application of osteoplastic materials allows for faster treatment outcomes, accelerate the regeneration of bone tissue in the area of the defect.

AIM

To examine the effectiveness of materials based on non-demineralized bone collagen and artificial hydroxylapatite when filling bone defects in outpatient surgical practice dentistry.

PATIENTS AND METHODS

22 patients with bone defects of various localization using osteoplastic materials were examined and treated. In our study, two groups were allocated on the etiology of bone loss: radicular cysts and chronic generalized periodontitis. Basic methods of diagnosis and monitoring of treatment in the work presented with the cone-beam computed tomography and digital orthopantomography.

RESULTS

Application of the testing osteoplastic materials resulted in faster recovery times with a combination of bone defects using resorbable membranes or gel enriched fibrin. In all 22 patients both tested materials were well tolerated, allergic reactions were not identified. However, five patients with a history of endocrinological history, during which treatment material is applied on the basis non-demineralized bone collagen, the degree of osseointegration has been reduced by 25% compared to the somatic healthy patients. In 3 patients with a history of hematological history, during which the treatment was applied material on the basis of artificial hydroxyapatite, the regeneration of the bone defect was reduced by 20%, which suggests the influence of somatic condition of the patient on the regeneration of bone tissue. Currently, all patients are on dynamic monitoring, recurrence has been detected.

CONCLUSION

Materials based on non-demineralized bone collagen and hydroxyapatite artificial equally successful during the replacement of the bone defect during surgery. However, the degree of regeneration may be different if the patient has a history of aggeravated that should be considered when planning treatment.

摘要

背景

手术过程中出现骨缺损时,并非总是进行骨替代材料填充,这会导致愈合时间延长、骨再生及治疗效果受影响。应用骨替代材料可实现更快的治疗效果,加速缺损区域骨组织的再生。

目的

在门诊口腔外科实践中,研究基于非脱矿骨胶原和人工羟基磷灰石的材料填充骨缺损的有效性。

患者与方法

对22例使用骨替代材料的不同部位骨缺损患者进行检查和治疗。在本研究中,根据骨质流失的病因分为两组:根囊肿和慢性广泛性牙周炎。工作中诊断和监测治疗的基本方法采用锥形束计算机断层扫描和数字化曲面断层摄影。

结果

使用测试的骨替代材料结合可吸收膜或富含纤维蛋白的凝胶,可使骨缺损愈合时间更快。所有22例患者对两种测试材料耐受性良好,未发现过敏反应。然而,5例有内分泌病史的患者,在使用基于非脱矿骨胶原的治疗材料时,与身体健康的患者相比,骨整合程度降低了25%。3例有血液病史的患者,在使用基于人工羟基磷灰石的治疗材料时,骨缺损的再生减少了20%,这表明患者的身体状况对骨组织再生有影响。目前,所有患者均在进行动态监测,未检测到复发。

结论

基于非脱矿骨胶原和人工羟基磷灰石的材料在手术中替代骨缺损时同样成功。然而,如果患者有加重病史,再生程度可能不同,在制定治疗计划时应予以考虑。

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