Stoor Patricia, Apajalahti Satu, Kontio Risto
*Department of Oral and Maxillofacial Surgery, Helsinki University Hospital †Department of Radiology, University of Helsinki and HUS Radiology (Medical Imaging Center), Helsinki, Finland.
J Craniofac Surg. 2017 Jul;28(5):1197-1205. doi: 10.1097/SCS.0000000000003649.
Cysts and tumors are common lesions in the jaws. To be able to retain a good volume of the alveolar ridge during healing as well as strengthening the angle and body of the mandible and provide an instant improved support for adjacent teeth, reliable long-term bone regeneration is needed. The purpose of this prospective study was to promote bone regeneration by filling bony defects in the upper or lower jaw with granules of the bioactive glass S53P4 (BAG), which have osteostimulative and antimicrobial properties.The authors treated 20 patients (21 defects) surgically; benign tumors, cysts, or infection related to impacted teeth in the maxilla or mandible. The tumor or cyst was removed or enucleated and thorough cleaning of the infected area was performed. The bone cavity was filled with granules of the BAG S53P4 despite signs of chronic infection in the area at the time of surgery. The patients were followed up for an average of 34 months clinically and with cone beam computerized tomography for 28 months. In 20 defects the final outcome was successful. Despite infection at the time of surgery in 65% of the patients, no material associated infection was seen during the follow-up. The BAG S53P4 granules were radiologically remodeled into bone after 2 years follow-up. The use of granules of the BAG S53P4 in the treatment of large bone defects provides infection-free reliable bone regeneration despite chronic infection at the time of surgery, which improves the prognosis of adjacent teeth.
囊肿和肿瘤是颌骨常见的病变。为了在愈合过程中保留足够体积的牙槽嵴，同时加强下颌骨的角部和体部，并为相邻牙齿提供即时改善的支撑，需要可靠的长期骨再生。这项前瞻性研究的目的是通过用具有骨刺激和抗菌特性的生物活性玻璃S53P4（BAG）颗粒填充上颌或下颌的骨缺损来促进骨再生。作者对20例患者（21处缺损）进行了手术治疗；上颌或下颌与阻生牙相关的良性肿瘤、囊肿或感染。切除或摘除肿瘤或囊肿，并对感染区域进行彻底清理。尽管手术时该区域有慢性感染迹象，但骨腔仍用BAG S53P4颗粒填充。对患者进行了平均34个月的临床随访，并用锥形束计算机断层扫描随访了28个月。在20处缺损中，最终结果是成功的。尽管65%的患者在手术时有感染，但随访期间未发现与材料相关的感染。经过2年的随访，BAG S53P4颗粒在放射学上被重塑为骨。在治疗大的骨缺损时使用BAG S53P4颗粒，尽管手术时有慢性感染，但仍能提供无感染的可靠骨再生，从而改善相邻牙齿的预后。
