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综合三维锥形束 CT 评估自体髂骨松质骨联合脱蛋白牛骨单侧牙槽裂重建:临床回顾性评估。

Comprehensive three-dimensional cone beam computed tomography assessment unilateral alveolar cleft reconstruction using autologous iliac cancellous bone combined with deproteinized bovine bone: A clinical retrospective evaluation.

机构信息

State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China; The Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, China.

The Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, China.

出版信息

J Craniomaxillofac Surg. 2024 Sep;52(9):1035-1041. doi: 10.1016/j.jcms.2024.06.002. Epub 2024 Jun 10.

Abstract

Large-volume autologous iliac cancellous bone grafting for alveolar cleft may lead to undesirable bone resorption and susceptible donor-site morbidity, whereas the addition of deproteinized bovine bone (DBB) could optimize outcomes. This study aimed to evaluate the effectiveness of combining autologous iliac bone with DBB using three-dimensional cone beam computed tomography (3D-CBCT) for better analysis of bone generation than conventional evaluation methods. Thirty-six patients with unilateral alveolar cleft were assigned into two groups. Group A (n = 21) underwent autogenous cancellous bone graft harvested from the anterior iliac crests, while Group B (n = 15) received a composite of autogenous iliac cancellous bone and DBB. Patients in Group B displayed higher bone filling rates (P < 0.0001) and lower bone absorption rates (P < 0.001) than those in Group A at both 6 months and 1 year postoperatively. Additionally, there were directional differences in bone absorption within the bone grafts, with more absorption observed on the alveolar crest and palatal sides than that on the nasal and labial sides (P < 0.001). This study demonstrates that employing a combination of DBB and autologous bone in alveolar cleft repair achieves better outcomes of bone grafting.

摘要

大量自体髂骨松质骨移植治疗牙槽裂可能导致不可取的骨吸收和易发生供区并发症,而添加脱蛋白牛骨(DBB)可以优化治疗效果。本研究旨在通过三维锥形束 CT(3D-CBCT)评估自体髂骨与 DBB 联合使用的效果,以便比传统评估方法更好地分析骨生成。36 例单侧牙槽裂患者分为两组。A 组(n=21)接受取自髂前嵴的自体松质骨移植,B 组(n=15)接受自体髂骨松质骨和 DBB 复合材料。B 组的骨填充率(P<0.0001)和骨吸收率(P<0.001)在术后 6 个月和 1 年均高于 A 组。此外,骨移植内的骨吸收存在方向差异,牙槽嵴和腭侧的吸收多于鼻侧和唇侧(P<0.001)。本研究表明,在牙槽裂修复中采用 DBB 和自体骨联合应用可获得更好的骨移植效果。

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