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5 种不同骨移植材料在人类上颌窦重建中三维容积变化的随机临床研究。

Three-dimensional volumetric changes of 5 different bone grafts in human maxillary sinuses reconstruction: a randomized clinical study.

机构信息

Universidade Estadual Paulista - UNESP, Ilha Solteira, Brazil.

Universidade do Grande Rio - UNIGRANRIO, Duque de Caxias, Brazil.

出版信息

Oral Maxillofac Surg. 2021 Dec;25(4):541-547. doi: 10.1007/s10006-021-00940-4. Epub 2021 Mar 13.

Abstract

PURPOSE

This study aimed to compare the three-dimensional volumetric changes of human maxillary sinuses after reconstruction using 5 different bone grafts.

PATIENTS AND METHODS

Patients underwent unilateral maxillary sinus bone height reconstruction using 5 bone substitutes allocated in different groups as follows: group 1 was grafted with autogenous bone graft alone; group 2 with beta-tricalcium phosphate (β-TCP); group 3 with β-TCP + autogenous bone graft 1:1; group 4 with bioactive glass; and group 5 with bioactive glass + autogenous bone graft 1:1. The patients were submitted to cone beam computed tomography in two periods: 15 days after the surgical procedure (T1) and after 6 months (T2). The results were evaluated as the formula T2-T1 expressing the three-volumetric changes of the biomaterials in elapsed time.

RESULTS

The resorption rate of autogenous bone graft was -630.699 ± 300.9 mm; in the β-TCP group, it was -315.772 ± 125.6 mm; in the group with β-TCP + autogenous bone graft 1:1, it was -336.205 ± 195.7 mm; and in groups with bioactive glass and with the addition of autogenous bone graft 1:1, it was -428.878 ± 311.6 mm and -576.917 ± 471.6 mm, respectively, without statistical difference (p = 0.167). Pearson's correlated test revealed a strong correlation as well as a progressive resorption of the grafts during bone healing.

CONCLUSION

The similar outcomes for the three-dimensional volumetric changes using the bone substitutes evaluated after 6 months of bone healing suggest that all these grafts can be performed to maxillary sinus reconstruction.

摘要

目的

本研究旨在比较 5 种不同骨移植物重建人上颌窦后三维容积变化。

方法

患者接受单侧上颌窦骨高度重建,5 种骨替代物分别分配到不同组如下:组 1 单纯自体骨移植;组 2 磷酸三钙(β-TCP);组 3 β-TCP+自体骨 1:1;组 4 生物活性玻璃;组 5 生物活性玻璃+自体骨 1:1。患者在两个时期接受锥形束 CT 检查:手术 15 天后(T1)和 6 个月后(T2)。结果以公式 T2-T1 表示生物材料在时间流逝中的三维体积变化。

结果

自体骨移植的吸收率为-630.699±300.9mm;β-TCP 组为-315.772±125.6mm;β-TCP+自体骨 1:1 组为-336.205±195.7mm;生物活性玻璃组和添加自体骨 1:1 组分别为-428.878±311.6mm 和-576.917±471.6mm,差异无统计学意义(p=0.167)。Pearson 相关检验显示,随着骨愈合,移植物具有较强的相关性和渐进性吸收。

结论

6 个月骨愈合后评估的骨替代物三维容积变化相似,表明所有这些移植物均可用于上颌窦重建。

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