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在患有口腔颌面裂和颅面畸形的患者中,使用脱矿骨基质(DBM)或自体骨移植进行Le Fort I型截骨术的术后并发症和再次手术率的比较。

Comparison of Postoperative Complications and Reoperation Rates of Le Fort I Osteotomies Using Demineralized Bone Matrix (DBM) or Autogenous Bone Grafts in Patients with Orofacial Clefts and Craniofacial Malformations.

作者信息

Sipos Noémi, Leikola Junnu, Heliövaara Arja, Kormi Eeva, Suojanen Juho

机构信息

Cleft Palate and Craniofacial Centre, Department of Plastic Surgery, Helsinki University Hospital and University of Helsinki, 00029 Helsinki, Finland.

Päijät-Häme Joint Authority for Health and Wellbeing, Department of Oral and Maxillofacial Surgery, Päijät-Häme Central Hospital, 15850 Lahti, Finland.

出版信息

Dent J (Basel). 2025 Jun 9;13(6):256. doi: 10.3390/dj13060256.

Abstract

This study aims to evaluate surgical outcomes and compares the prevalence and severity of postoperative complications and reoperations with maxillary osteotomies, focusing on the effectiveness of fixation with demineralized bone matrix (DBM) versus autogenous bone grafts (ABG) in patients with orofacial clefts and craniofacial malformations. This retrospective cohort study included 138 consecutive patients treated at the Cleft Palate and Craniofacial Center, Helsinki University Hospital, from 2014 to 2022. The cohort consisted of patients with clefts ( = 113), craniosynostosis, and craniofacial syndromes ( = 25). The DBM group ( = 103) received DBX (Musculoskeletal Transplant Foundation, Edison, NJ, USA), while the ABG group ( = 35) received autogenous bone grafts. Surgical procedures included Le Fort I and bimaxillary osteotomies. Complications involving the maxilla or both jaws were included in the analysis. Both major and minor complications, as well as reoperations, were analyzed and compared. The DBM group had 13.6% of patients with complications, while the ABG group had 20.0%. Reoperation rates were 6.8% for the DBM group and 5.7% for the ABG group. There were no statistically significant differences in complication or reoperation rates between the DBM and ABG groups. The findings suggest that using DBM or ABG in maxillary osteotomies does not significantly affect complication or reoperation rates, supporting DBM as a viable alternative for maxillary surgeries.

摘要

本研究旨在评估手术效果,并比较上颌骨截骨术后并发症和再次手术的发生率及严重程度,重点关注脱矿骨基质(DBM)与自体骨移植(ABG)在口腔颌面裂和颅面畸形患者中的固定效果。这项回顾性队列研究纳入了2014年至2022年在赫尔辛基大学医院腭裂与颅面中心接受治疗的138例连续患者。该队列包括腭裂患者(n = 113)、颅缝早闭和颅面综合征患者(n = 25)。DBM组(n = 103)接受DBX(美国新泽西州爱迪生市肌肉骨骼移植基金会),而ABG组(n = 35)接受自体骨移植。手术程序包括Le Fort I型截骨术和双颌截骨术。涉及上颌骨或上下颌骨的并发症纳入分析。对主要和次要并发症以及再次手术进行了分析和比较。DBM组有13.6%的患者出现并发症,而ABG组为20.0%。DBM组的再次手术率为6.8%,ABG组为5.7%。DBM组和ABG组在并发症或再次手术率方面没有统计学上的显著差异。研究结果表明,在上颌骨截骨术中使用DBM或ABG不会显著影响并发症或再次手术率,支持将DBM作为上颌手术的一种可行替代方案。

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