Department of Oral and Maxillofacial Surgery, 12 de Octubre University Hospital, Av. de Córdoba, 28041 Madrid, Spain.
Department of Oral and Maxillofacial Surgery, 12 de Octubre University Hospital, Av. de Córdoba, 28041 Madrid, Spain.
J Craniomaxillofac Surg. 2022 Aug;50(8):657-663. doi: 10.1016/j.jcms.2022.06.008. Epub 2022 Jul 5.
This study's objective is to determine if the combined use of bone substitutes and collagen membranes is related to worse postoperative outcomes after intra-osseous oral cystectomies. Additional risk factors mentioned in the existing literature were retrospectively analysed by reviewing the medical records and imaging tests of adult patients. Age, gender, smoking habit, cyst location, size, shape, histopathology, perilesional osteosclerosis and associated intracystic third molars were registered. The type of biomaterials applied and the number of bony walls remaining after surgery were also identified. All factors were analysed in relation to wound dehiscence and postoperative infection. Simple and multiple logistic regression analyses were performed to exclude possible confounding effects between the risk factors identified. In a sample of 211 cystectomies, guided bone regeneration was not significantly associated with infection, only the presence of impacted third molars was (p = 0.0219). This finding remained true, even in cysts larger than 25 mm. However, the risk of wound dehiscence was 4.9 times higher when biomaterials were applied (CI 95%, 1.6818-12.8274, p = 0.0014). In accordance with recent studies, these findings suggest that whenever guided bone regeneration might prove useful after cyst enucleation, avoiding chemically cross-linked membranes should be considered.
本研究旨在确定在骨内口腔囊切除术术后,骨替代物和胶原膜的联合使用是否与较差的术后结果相关。通过回顾成年患者的病历和影像学检查,分析了现有文献中提到的其他相关风险因素。记录了年龄、性别、吸烟习惯、囊肿位置、大小、形状、组织病理学、病变周围骨硬化和相关囊内第三磨牙。还确定了应用的生物材料类型和手术后残留的骨壁数量。所有因素均与伤口裂开和术后感染进行分析。进行简单和多重逻辑回归分析以排除所确定的风险因素之间可能存在的混杂影响。在 211 例囊切除术样本中,引导骨再生与感染无显著相关性,只有存在埋伏第三磨牙时才相关(p=0.0219)。即使在大于 25mm 的囊肿中,这一发现仍然成立。然而,当应用生物材料时,伤口裂开的风险增加了 4.9 倍(CI 95%,1.6818-12.8274,p=0.0014)。与最近的研究一致,这些发现表明,只要引导骨再生在囊切除术后可能有用,就应考虑避免使用化学交联膜。