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二水硫酸钙作为牙源性颌骨囊肿摘除术后骨缺损替代材料的疗效:一项临床研究。

Efficacy of calcium sulfate dihydrate as a bone graft substitute in odontogenic cystic defects of jaws following enucleation: A clinical study.

作者信息

Tayshetye Radhika Shashank, Bhola Nitin, Deshpande Nupoor, Agrawal Anchal

机构信息

Department of Oral and Maxillofacial Surgery, Sharad Pawar Dental College, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra, India.

出版信息

Natl J Maxillofac Surg. 2023 Jan-Apr;14(1):125-129. doi: 10.4103/njms.NJMS_350_21. Epub 2023 Apr 14.

Abstract

BACKGROUND

The treatment of osseous bone defects created following enucleation of a cyst is an arduous challenge. Autogenous bone grafts despite being the gold standard have various drawbacks such as donor site morbidity, limited availability of bone graft, and increased operative time. Hence, there are various bone grafts which are being investigated which could overcome the limitations of autografts. Thus, this study was conducted to evaluate the efficacy of calcium sulfate (CS), a bone graft substitute, for spontaneous bone regeneration of cystic defects.

OBJECTIVES

The purpose of this study is to evaluate bone formation in odontogenic cystic defects following enucleation and reconstruction with bone graft substitute by three-dimensional radiographic and clinical evaluation.

METHODOLOGY

A total of twenty patients diagnosed with odontogenic cysts were randomly divided into two groups, out of which the study group had undergone enucleation with bone grafting (tobramycin-impregnated CS dihydrate) and the control group had undergone enucleation without bone grafting. The patients were evaluated clinically and radiographically at the 1, 3, 6, and 12 months postoperatively.

RESULTS

There was no bone formation observed at 1 month postoperative in both the groups. There was a statistically significant higher bone defect reduction observed radiologically on orthopantomogram and computed tomography scan in the study group than the control group at the 3, 6, and 12 months postoperative. The rate of reduction in cystic volume of the study group at the 12 month was 94.4% and in the control group was 37.16%.

CONCLUSION

Immediate grafting of cystic cavity can avoid complications such as pathological fracture due to less bone support, delayed healing, etc., The utilization of a graft with a property of inducing rapid bone formation should be taken into consideration. The use of CS as a grafting material accelerated the rate of bone regeneration in the cystic defects, with minimal complications.

摘要

背景

囊肿摘除术后形成的骨性骨缺损的治疗是一项艰巨的挑战。自体骨移植尽管是金标准,但有各种缺点,如供区并发症、骨移植可用性有限以及手术时间增加。因此,正在研究各种可克服自体骨移植局限性的骨移植材料。因此,本研究旨在评估骨移植替代物硫酸钙(CS)对囊性缺损自发骨再生的疗效。

目的

本研究的目的是通过三维影像学和临床评估,评估摘除术后并用骨移植替代物重建的牙源性囊性缺损中的骨形成情况。

方法

总共20例被诊断为牙源性囊肿的患者被随机分为两组,其中研究组接受了囊肿摘除并植骨(妥布霉素浸渍的二水合CS),对照组接受了囊肿摘除但未植骨。在术后1、3、6和12个月对患者进行临床和影像学评估。

结果

两组术后1个月均未观察到骨形成。术后3、6和12个月,研究组在曲面断层片和计算机断层扫描上的影像学骨缺损减少在统计学上显著高于对照组。研究组在12个月时囊肿体积减少率为94.4%,对照组为37.16%。

结论

立即对囊腔进行植骨可避免诸如因骨支撑不足导致的病理性骨折、愈合延迟等并发症,应考虑使用具有诱导快速骨形成特性的移植材料。使用CS作为移植材料可加速囊性缺损中的骨再生速度,且并发症最少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb70/10235741/815e4046fbd7/NJMS-14-125-g001.jpg

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