Gali Raja Sekhar, Devireddy Sathya Kumar, Mohan Rao N, Kishore Kumar R V, Kanubaddy Sridhar Reddy, Dasari Mallikarjuna, Sowjanya K, Pathapati Rama Mohan
Deprtment of Oral and Maxillofacial Surgery, Narayana Dental College & Hospital, Nellore, Andhra Pradesh 524003 India.
Department of Pathology, Narayana Dental College & Hospital, Nellore, Andhra Pradesh 524003 India.
J Maxillofac Oral Surg. 2017 Mar;16(1):71-78. doi: 10.1007/s12663-016-0924-4. Epub 2016 Jun 10.
This prospective study was conducted to evaluate the bone regeneration capacity of synthetic hydroxyapatite mixed with autogenous bone marrow aspirate when used as a bone graft substitute in maxillo-mandibular osseous defects.
This study included nine patients with histopathalogically proven benign osteolytic lesions in maxilla and mandible that were treated with enucleation or marginal resection followed by bone marrow aspirate coated synthetic biphasic hydroxyapatite (hydroxyapatite and beta tricalcium phosphate) graft placement. Incorporation of graft was assessed based on Irwin's radiologic staging. The efficacy of graft to form new bone was radiologically evaluated by observing the sequential changes of density at grafted site using gray scale level histogram which was processed in adobe photoshop 7.0 elements. Clinical assessment of recipient and donor sites was done.
Based on Irwin's radiologic staging, at 6 month follow up period, obvious incorporation of graft with new bone was observed. Sequential changes in bone density measured by gray scale histogram revealed initial resorption followed by replacement of BMA coated hydroxyapatite with new bone formation. None of the patients eventually had complications like infection, wound dehiscence, graft loss at recipient sites at 6 months follow up period.
Autogenous bone marrow aspirate in combination with synthetic hydroxyapatite is an effective option for accelerating bone regeneration in small to moderate sized jaw bone defects. This mixture provides all the three critical elements needed for bone regeneration (osteogenesis, osteoinduction and osteoconduction) with an added advantage of obviating donor site morbidity.
本前瞻性研究旨在评估合成羟基磷灰石与自体骨髓抽吸物混合用作颌骨骨缺损的骨移植替代物时的骨再生能力。
本研究纳入了9例经组织病理学证实的上颌骨和下颌骨良性溶骨性病变患者，这些患者接受了摘除术或边缘切除术，随后植入了涂有骨髓抽吸物的合成双相羟基磷灰石（羟基磷灰石和β-磷酸三钙）移植物。根据欧文的放射学分期评估移植物的整合情况。通过使用在Adobe Photoshop 7.0 Elements中处理的灰度级直方图观察移植部位密度的连续变化，对移植物形成新骨的效果进行放射学评估。对受区和供区进行了临床评估。
根据欧文的放射学分期，在6个月的随访期内，观察到移植物与新骨明显整合。通过灰度直方图测量的骨密度连续变化显示，最初有吸收，随后BMA涂层的羟基磷灰石被新骨形成所替代。在6个月的随访期内，没有患者最终出现感染、伤口裂开、受区移植物丢失等并发症。
自体骨髓抽吸物与合成羟基磷灰石联合使用是加速中小尺寸颌骨缺损骨再生的有效选择。这种混合物提供了骨再生所需的所有三个关键要素（成骨、骨诱导和骨传导），并具有避免供区并发症的额外优势。
