U Vignesh, Mehrotra Divya, Howlader Debraj, Kumar Sumit, Anand Vaibhav
Department of Oral and Maxillofacial Surgery.
Department of Health Research-Multidisciplinary Research Unit, King George Medical University, Lucknow, India.
J Craniofac Surg. 2019 May/Jun;30(3):e247-e251. doi: 10.1097/SCS.0000000000005200.
Autogenous or alloplastic bone grafts are routinely applied for reconstruction of cystic bone defects. Addition of mesenchymal bone marrow stem cell in osteoconductive alloplastic bone makes it osteoinductive and osteogenic. The purpose of this study was to evaluate the role of bone marrow aspirate in regenerating new bone with hydroxyapatite collagen scaffold in patients with large cystic maxillofacial defects. This prospective randomized study had random allocation of 15 patients with large cystic maxillofacial bony defects in each of the 2 groups. Group I patients received hydroxyapatite granules and bone marrow aspirate in collagen sponge and group II received hydroxyapatite granules only. Clinical and radiologic assessment showed the time taken in bone healing. In group I, the bone defect volume reduction was statistically significant at 3 and 6 months, the postoperative pain and swelling was less, and there was no tooth mobility at 3 months. The authors concluded that use of hydroxyapatite granules with bone marrow aspirate in collagen sponge in maxillofacial bone defects provided early bone regeneration, and faster wound healing. However, to arrive at a definitive conclusion a long-term study with a larger sample size is required.
自体骨或异体骨移植常用于囊性骨缺损的修复。在具有骨传导性的异体骨中添加间充质骨髓干细胞可使其具有骨诱导性和成骨性。本研究的目的是评估骨髓抽吸物在大囊性颌面部缺损患者中与羟基磷灰石胶原支架共同促进新骨再生的作用。这项前瞻性随机研究将15例大囊性颌面部骨缺损患者随机分为2组。第一组患者在胶原海绵中接受羟基磷灰石颗粒和骨髓抽吸物,第二组仅接受羟基磷灰石颗粒。临床和影像学评估显示了骨愈合所需的时间。在第一组中,3个月和6个月时骨缺损体积减少具有统计学意义,术后疼痛和肿胀较轻,3个月时无牙齿松动。作者得出结论,在颌面部骨缺损中使用胶原海绵包裹的羟基磷灰石颗粒和骨髓抽吸物可实现早期骨再生和更快的伤口愈合。然而,要得出明确结论,需要进行更大样本量的长期研究。