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45S5 生物玻璃,作为腭裂二次牙槽骨移植自体采骨的替代方法是否可行?100 例手术的回顾性研究。

Bioglass 45S5, a relevant alternative to autogenous harvesting for secondary alveolar bone grafts in clefts? Retrospective study of one hundred surgeries.

机构信息

CHU Rennes, Univ Rennes, Service de Chirurgie Pédiatrique, France.

CHU Rennes, Univ Rennes, Pôle Odontologie, France.

出版信息

J Craniomaxillofac Surg. 2024 Jan;52(1):85-92. doi: 10.1016/j.jcms.2023.12.005. Epub 2023 Dec 16.

Abstract

The secondary alveolar bone grafting (SABG) step restores the continuity of the alveolar bone necessary for dentition. Faced with the complications of autografts, synthetic biomaterials such as Bioglass (BG) 45S5 have been proposed. The objective was to evaluate the success rate of SABG with the addition of BG 45S5 and to highlight the prognostic factors. Patients who underwent operation between 2015 and 2021 and had follow-up cone-beam computed tomography (CBCT) were analyzed. Multivariate analysis was performed to determine factors influencing radiographic success. A total of 102 SABG were analyzed. They were unilateral total cleft lip and palate (49, 48.0%). The mean age at surgery was 9.32 ± 3.09 years. Surgeries were performed mainly outside a syndromic context and without a family history after orthodontic preparation. The radiographic success rate at 1 year was 80.4%. Mixed dentition stage (odds ratio [OR] = 7.3, p = 0.024), absence of syndromic context (OR = 20.7, p = 0.024) and female sex (OR = 4.88, p = 0.021) were factors predictive of surgical success. The use of BG 45S5 instead of autograft is relevant for SABG, with a 1-year success rate of over 80%. The stage of mixed dentition, the absence of syndromic context, and female sex were factors for good prognosis.

摘要

次级牙槽骨移植 (SABG) 步骤可恢复牙列所需的牙槽骨连续性。面对自体移植物的并发症,已经提出了诸如 Bioglass (BG) 45S5 之类的合成生物材料。目的是评估添加 BG 45S5 的 SABG 的成功率,并突出预后因素。分析了 2015 年至 2021 年期间接受手术且具有随访锥形束计算机断层扫描 (CBCT) 的患者。进行了多变量分析以确定影响影像学成功的因素。共分析了 102 例 SABG。其中单侧完全性唇腭裂 49 例(48.0%)。手术时的平均年龄为 9.32 ± 3.09 岁。手术主要在正畸准备后非综合征性环境中进行,且无家族史。1 年时的影像学成功率为 80.4%。混合牙列期(优势比 [OR] = 7.3,p = 0.024)、无综合征性背景(OR = 20.7,p = 0.024)和女性(OR = 4.88,p = 0.021)是手术成功的预测因素。与自体移植物相比,使用 BG 45S5 进行 SABG 是相关的,其 1 年成功率超过 80%。混合牙列期、无综合征性背景和女性是良好预后的因素。

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