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颌面部牵张成骨的评估

Evaluation of Transport Distraction Osteogenesis in Maxillofacial Region.

作者信息

Vishwakarma Ajit Kumar, Dhiman Neeraj Kumar, Sharma Naresh Kumar, Jaiswara Chandresh, Tiwari Preeti, Hirani Mehul Shashikant

机构信息

Department of Dentistry, Government Medical College, Azamgarh, Uttar Pradesh India.

Unit of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.

出版信息

J Maxillofac Oral Surg. 2025 Feb;24(1):188-199. doi: 10.1007/s12663-024-02137-0. Epub 2024 Mar 12.

Abstract

INTRODUCTION

Transport distraction osteogenesis (TDO) is a novel reconstructive modality for mandibular ablative defects, precluding donor site morbidity. Assessing of TDO regenerate that could assist in modifying the distraction strategy for patient specific needs.

MATERIALS AND METHODS

Present study enrolled 17 patients with mandibular defects of size < 12 cm, divided in two groups ≤35 years (A) and > 35 years (B); and assessed the TDO regenerate by clinically examining intra as well as post operatively, using orthopantomogram (OPG), ultrasonography (USG), color Doppler (CD) and cone beam computed tomography (CBCT).

RESULTS

Group B had a longer latency period ( = 0.001) and consolidation period ( = 0.002) than group A. Paired sample correlation study of clinical defect and TDO regenerate ( 0.004) indicate that a better length of regenerate is possible with TDO in mandibular defects. OPG, USG and CBCT shown a significant difference in bone mineralization observed within different age groups except for CD. USG representing earlier detection of mineralization than OPG over the consolidation period.

CONCLUSION

Use of TDO for reconstruction of mandibular defects is advantageous as the regenerated bone and soft tissues matches the existing anatomical tissues. Evaluation by USG, OPG and CBCT could aid in providing patient specific protocols for TDO in Maxillofacial region.

摘要

引言

运输性牵张成骨术(TDO)是一种用于下颌骨缺损重建的新型方法,可避免供区并发症。评估TDO再生情况有助于根据患者的具体需求调整牵张策略。

材料与方法

本研究纳入了17例下颌骨缺损长度<12 cm的患者,分为两组,年龄≤35岁的为A组,年龄>35岁的为B组;通过术中及术后的临床检查、使用曲面断层片(OPG)、超声检查(USG)、彩色多普勒(CD)和锥形束计算机断层扫描(CBCT)来评估TDO再生情况。

结果

B组的延迟期(P = 0.001)和巩固期(P = 0.002)均长于A组。临床缺损与TDO再生的配对样本相关性研究(P = 0.004)表明,TDO在下颌骨缺损中有可能实现更好的再生长度。除CD外,OPG、USG和CBCT显示不同年龄组之间观察到的骨矿化存在显著差异。在巩固期,USG比OPG能更早检测到矿化。

结论

使用TDO重建下颌骨缺损具有优势,因为再生的骨和软组织与现有的解剖组织相匹配。通过USG、OPG和CBCT进行评估有助于为颌面区域的TDO提供针对患者的方案。

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