在 Le Fort I 骨切开术中，牛骨替代物与自体骨移植的前瞻性组织形态计量学和头影测量学比较。

A prospective histomorphometric and cephalometric comparison of bovine bone substitute and autogenous bone grafting in Le Fort I osteotomies.

机构信息

Department of Oral and Maxillofacial Surgery, (Head: Prof. Dr. Dr. Siegmar Reinert, MD, DMD, PhD), University Hospital Tuebingen, Osianderstrasse 2-8, 72076 Tuebingen, Germany.

Department of Oral and Maxillofacial Surgery, (Head: Prof. Dr. Dr. Rainer Schmelzeisen, MD, DMD, PhD), University Hospital Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany.

出版信息

J Craniomaxillofac Surg. 2019 Feb;47(2):233-238. doi: 10.1016/j.jcms.2018.11.032. Epub 2018 Dec 6.

DOI:10.1016/j.jcms.2018.11.032

PMID:30591394

Abstract

PURPOSE

The aim of the present study was the histomorphometric and cephalometric comparison of autogenous bone grafting of the anterior iliac crest and the application of bovine bone substitute concerning new bone formation and postoperative stability in patients undergoing orthognathic Le Fort I osteotomy.

PATIENTS AND METHODS

Twenty-five patients requiring orthognathic surgery with Le Fort I osteotomy were included in this study. Patients were randomly divided into three groups receiving either autogenous iliac crest BONE grafting (BONE; n = 8) or xenogenic bovine bone grafting (Bio-Oss) in INTER (n = 12) or in ONLAY (n = 5) position. Histomorphometric analysis was performed using trephine bone biopsies from the autogenous, respectively xenogenic bone grafting region. Postoperative stability was evaluated using teleradiographies of three different timepoints.

RESULTS

All groups showed comparable mineralized fractions in bone biopsies of 50.2% (±13.2%) INTER, 46.48% (±12.3%) ONLAY and 57.1% (±20.6%) BONE as well as comparable percentage of connective tissue. Patients in the INTER-group revealed the lowest relapse rate of 20.5% (INTER) compared to 30.3% (ONLAY) and 33.0% (BONE). All groups underwent comparable maxillary advancement and healing time.

CONCLUSIONS

Present results indicate that block shaped bovine bone substitute is a promising alternative to autogenous bone grafting to bridge the Le Fort I osteotomy gap in orthognathic surgery.

摘要

目的

本研究的目的是比较自体髂嵴骨移植和牛骨替代物在前额髂嵴中的组织形态计量学和头影测量学，以观察在接受正颌 Le Fort I 截骨术的患者中，新骨形成和术后稳定性。

患者和方法

本研究纳入了 25 例需要接受正颌手术 Le Fort I 截骨术的患者。患者随机分为三组，分别接受自体髂嵴骨移植（BONE；n=8）、异种牛骨移植（Bio-Oss）置于 INTER（n=12）或 ONLAY（n=5）位置。使用自体和异种骨移植区域的环钻骨活检进行组织形态计量学分析。使用三个不同时间点的远程放射照片评估术后稳定性。

结果

所有组的骨活检中的矿化分数均相似，分别为 50.2%（±13.2%）INTER、46.48%（±12.3%）ONLAY 和 57.1%（±20.6%）BONE，以及相似的结缔组织百分比。INTER 组的复发率最低，为 20.5%（INTER），而 ONLAY 组和 BONE 组分别为 30.3%和 33.0%。所有组的上颌骨均有相似的推进和愈合时间。