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自体皮质松质骨移植联合富血小板血浆加或不加Bio-Oss用于单侧牙槽嵴裂缺损骨再生的疗效:一项随机对照试验。

Efficacy of autologous cortico-cancellous bone graft and platelet-rich plasma with or without Bio-Oss in bone regeneration for unilateral alveolar cleft defects: A randomized controlled trial.

作者信息

Puvvada Divya, Chittamuru Naveen, Raju U Shivaji, Vadupu Meghana, Thirumalareddy Mounica, Sravani Pampana

机构信息

Department of Oral and Maxillofacial Surgery, Vishnu Dental College, Bhimavaram, India.

Department of Oral and Maxillofacial Surgery, Vishnu Dental College, Bhimavaram, India.

出版信息

J Stomatol Oral Maxillofac Surg. 2025 Sep;126(4S):102256. doi: 10.1016/j.jormas.2025.102256. Epub 2025 Jan 18.

Abstract

INTRODUCTION

Alveolar cleft grafting is crucial in cleft lip and palate rehabilitation, promoting maxillary continuity and facilitating dental development. While autologous bone grafts are the gold standard, combining them with platelet-rich plasma (PRP) and xenografts like Bio-Oss has the potential to enhance bone regeneration and long-term stability. This study aimed to evaluate the synergistic effects of combining autologous cortico-cancellous bone grafts, PRP, and Bio-Oss in alveolar cleft repair.

MATERIALS AND METHODS

Twenty patients (aged 8-25 years) with unilateral cleft lip and palate were randomly divided into two groups. Group A received autologous cortico-cancellous bone grafts combined with PRP, while Group B received the same grafts with PRP and Bio-Oss. Bone density, pain, and wound healing were assessed at various intervals up to one year postoperatively. Data were analysed using repeated measures ANOVA and Bonferroni post hoc tests.

RESULTS

Group B demonstrated significantly higher bone density (1028.5 ± 45.2 HU) at six months and one year compared to Group A (P < 0.05). Bone resorption occurred in both groups within the first three months, but Group B showed greater bone regeneration. No significant differences were noted in wound healing between the groups, though two patients in Group B experienced secondary healing due to infection.

CONCLUSION

The combination of autologous bone grafts, PRP, and Bio-Oss may enhance bone regeneration and stability in alveolar cleft repair. Further studies are needed to validate these findings and optimize clinical protocols.

摘要

引言

牙槽嵴裂植骨术在唇腭裂修复中至关重要,可促进上颌骨连续性并利于牙齿发育。虽然自体骨移植是金标准,但将其与富血小板血浆(PRP)以及Bio - Oss等异种移植物相结合,有可能增强骨再生和长期稳定性。本研究旨在评估自体皮质松质骨移植、PRP和Bio - Oss联合应用于牙槽嵴裂修复的协同作用。

材料与方法

20例单侧唇腭裂患者(年龄8 - 25岁)被随机分为两组。A组接受自体皮质松质骨移植联合PRP,而B组接受相同的移植材料并加用Bio - Oss。在术后长达一年的不同时间间隔评估骨密度、疼痛和伤口愈合情况。数据采用重复测量方差分析和Bonferroni事后检验进行分析。

结果

与A组相比,B组在术后6个月和1年时骨密度显著更高(1028.5±45.2 HU)(P < 0.05)。两组在术后前三个月均发生了骨吸收,但B组显示出更大的骨再生。两组间伤口愈合情况无显著差异,不过B组有两名患者因感染出现二期愈合。

结论

自体骨移植、PRP和Bio - Oss联合应用可能增强牙槽嵴裂修复中的骨再生和稳定性。需要进一步研究来验证这些发现并优化临床方案。

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