自体髂骨松质骨联合CGF修复治疗牙槽嵴裂的疗效及术后牙龈退缩情况分析
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摘要
目的:探究自体髂骨松质骨联合浓缩生长因子(ConcentratedGrowthFactor,CGF)修复治疗牙槽嵴裂的临床效果及术后牙龈退缩情况。方法:选取2017年3月-2018年6月在笔者医院治疗的60例先天性牙槽嵴裂患者为研究对象,采用随机数字法分为观察组和对照组,每组30例。所有患者均进行自体髂骨松质骨移植术,观察组在此基础上联合CGF治疗。术后3个月和术后6个月对两组患者均进锥形束计算机断层扫描(ConebeamComputerTomography,CBCT)检查,并采用Bergland分型比较两组患者牙槽嵴植骨效果和牙槽嵴裂隙内新生骨的最小垂直骨桥高度(ShortestverticalLengthofbone Bridge,SLB)、最小骨宽度(ShortestanteroposteriorBoneWidth,SBW)以及骨密度等相关指标,比较两组患者裂隙近中牙牙龈退缩情况。结果:术后6个月,观察组患者植骨总达标率(86.67%)明显高于对照组(63.33%),比较有显著性差异,具有统计学意义(P<0.05),两组临床分级均无IV级;观察组患者术3、6个月SLB、SBW值均明显大于对照组,有显著性差异,均有统计学意义(P<0.05);两组患者术后6个月SLB、SBW值与术后3个月比较均明显变小,但观察组骨吸收率明显低于对照组,比较有显著性差异,均有统计学意义(P<0.05);观察组患者术后6个月骨体积分数和骨密度均明显大于对照组,骨小梁分离度明显小于对照组,比较有显著性差异,均有统计学意义(P<0.05);术后6个月,两组患者裂隙近中牙牙龈退缩人数明显减少,且观察组明显少于对照组,有统计学意义(P<0.05)。结论:自体髂骨松质骨联合CGF修复治疗对先天性牙槽嵴临床疗效显著,可进一步改善植骨效果,减少骨吸收率,术后牙龈退缩情况得到有效改善。
Objective To investigate the clinical effect of autologous iliac cancellous bone combined with concentrated growth factor(CGF) in the treatment of alveolar cleft palate and its postoperative gingival recession. Methods Sixty patients with congenital alveolar cleft palate treated in our hospital from March 2017 to June 2018 were enrolled. The observation group and the control group were divided into 30 groups by random number method. All patients underwent autologous iliac bone grafting, and the observation group was combined with CGF treatment. All patients underwent CBCT examination 3 months after surgery and 6 months after surgery, and Bergland classification was used to compare the effect of alveolar bone grafting and new bone in the alveolar cleft. The shortest vertical length of bone bridge(SLB), shortest anteroposterior bone width(SBW) and bone density were compared with the indicators of the two groups of patients. Results The total compliance rate of bone grafts in the observation group(86.67%) was significantly higher than that in the control group(63.33%), and the difference was statistically significant(P<0.05). There was no grade IV in the clinical grades of the two groups. The SLB and SBW values of the observation group were significantly higher than those of the control group at 3 and 6 months, and the difference was statistically significant(P<0.05). The SLB of the two groups were 6 months after operation. The SBW value was significantly smaller than that of the 3 months after operation, but the bone resorption rate of the observation group was significantly lower than that of the control group, and the difference was statistically significant(P<0.05). The bone volume fraction of the observation group was 6 months after operation. The bone mineral density was significantly greater than that of the control group. The trabecular bone separation was significantly lower than that of the control group. The difference was statistically significant(P<0.05). At 6 months after operation, the number of gingival recession in the cleft of the two groups was significantly reduced. The observation group was significantly less than the control group, and the difference was statistically significant(P<0.05). Conclusion The autologous iliac cancellous bone combined with CGF repair has significant clinical effect on congenital alveolar ridge, which can further improve bone grafting. Effect, reduce bone resorption rate,postoperative gingival recession has been effectively changed.
Objective To investigate the clinical effect of autologous iliac cancellous bone combined with concentrated growth factor(CGF) in the treatment of alveolar cleft palate and its postoperative gingival recession. Methods Sixty patients with congenital alveolar cleft palate treated in our hospital from March 2017 to June 2018 were enrolled. The observation group and the control group were divided into 30 groups by random number method. All patients underwent autologous iliac bone grafting, and the observation group was combined with CGF treatment. All patients underwent CBCT examination 3 months after surgery and 6 months after surgery, and Bergland classification was used to compare the effect of alveolar bone grafting and new bone in the alveolar cleft. The shortest vertical length of bone bridge(SLB), shortest anteroposterior bone width(SBW) and bone density were compared with the indicators of the two groups of patients. Results The total compliance rate of bone grafts in the observation group(86.67%) was significantly higher than that in the control group(63.33%), and the difference was statistically significant(P<0.05). There was no grade IV in the clinical grades of the two groups. The SLB and SBW values of the observation group were significantly higher than those of the control group at 3 and 6 months, and the difference was statistically significant(P<0.05). The SLB of the two groups were 6 months after operation. The SBW value was significantly smaller than that of the 3 months after operation, but the bone resorption rate of the observation group was significantly lower than that of the control group, and the difference was statistically significant(P<0.05). The bone volume fraction of the observation group was 6 months after operation. The bone mineral density was significantly greater than that of the control group. The trabecular bone separation was significantly lower than that of the control group. The difference was statistically significant(P<0.05). At 6 months after operation, the number of gingival recession in the cleft of the two groups was significantly reduced. The observation group was significantly less than the control group, and the difference was statistically significant(P<0.05). Conclusion The autologous iliac cancellous bone combined with CGF repair has significant clinical effect on congenital alveolar ridge, which can further improve bone grafting. Effect, reduce bone resorption rate,postoperative gingival recession has been effectively changed.
引文
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[2]张岩,赵世俊,祁振江,等.CBCT对于牙槽嵴植骨术后效果评价的应用研究[J].中国美容医学,2016,25(10):57-60.
[3]庞超远,丁宇翔,秦瑞峰,等.不同骨缺损情况下牙槽嵴保存术对延期种植的影响[J].牙体牙髓牙周病学杂志,2014,13(5):286-290.
[4]Winnie P,Eve T,James G,et al.Spontaneous tooth eruption after alveolar cleft osteoplasty using tissue-engineered bone:a case report[J].Oral Surg Oral Med Oral Pathol Oral RadiolEndod,2008,105(4):440-444.
[5]姜群,傅国,毕先燕,等.口腔修复膜与自体髂骨联合移植在牙槽嵴裂植骨中的临床观察[J].口腔医学研究,2010,26(1):108-110.
[6]沈悦,马海英,张彦升,等.骨髓间充质干细胞膜片复合自体髂骨移植修复牙槽嵴裂[J].中国组织工程研究,2014,17(50):232-235.
[7]陈立艳,刘志杰,苑芳连,等.颧牙槽嵴区骨宽度及皮质骨厚度的CBCT测量分析[J].口腔医学研究,2017,33(6):637-641.
[8]Koole R.Ectomesenchymal mandibular symphysis bone graft:An improvement in alveolar cleft grafting[J].Cleft Palatecraniofac J,1994,31(31):217-223.
[9]Eichhorn W,Blessmann M,Pohlenz P,et al.Primary osteoplasty using calvarian bone in patients with cleft lip,alveolus and palate[J].JCraniomaxillofac Surg,2009,37(8):429-433.
[10]Sindetpedersen S,Enemark H.Mandibular bone grafts for reconstruction of alveolar clefts[J].J Oral Maxillofac Surg,1988,46(7):533-537.
[11]Takahashi T,Inai T,Kochi S,et al.Long-term follow-up of dental implants placed in a grafted alveolar cleft:evaluation of alveolar bone height[J].Oral Surg Oral Med Oral Pathol Oral Radiol Endod,2008,105(3):297-302.
[12]Marukawa E,Oshina H,Iino G,et al.Reduction of bone resorption by the application of platelet-rich plasma(PRP)in bone grafting of the alveolar cleft[J].J Craniomaxillofac Surg,2011,39(4):278-283.
[2]张岩,赵世俊,祁振江,等.CBCT对于牙槽嵴植骨术后效果评价的应用研究[J].中国美容医学,2016,25(10):57-60.
[3]庞超远,丁宇翔,秦瑞峰,等.不同骨缺损情况下牙槽嵴保存术对延期种植的影响[J].牙体牙髓牙周病学杂志,2014,13(5):286-290.
[4]Winnie P,Eve T,James G,et al.Spontaneous tooth eruption after alveolar cleft osteoplasty using tissue-engineered bone:a case report[J].Oral Surg Oral Med Oral Pathol Oral RadiolEndod,2008,105(4):440-444.
[5]姜群,傅国,毕先燕,等.口腔修复膜与自体髂骨联合移植在牙槽嵴裂植骨中的临床观察[J].口腔医学研究,2010,26(1):108-110.
[6]沈悦,马海英,张彦升,等.骨髓间充质干细胞膜片复合自体髂骨移植修复牙槽嵴裂[J].中国组织工程研究,2014,17(50):232-235.
[7]陈立艳,刘志杰,苑芳连,等.颧牙槽嵴区骨宽度及皮质骨厚度的CBCT测量分析[J].口腔医学研究,2017,33(6):637-641.
[8]Koole R.Ectomesenchymal mandibular symphysis bone graft:An improvement in alveolar cleft grafting[J].Cleft Palatecraniofac J,1994,31(31):217-223.
[9]Eichhorn W,Blessmann M,Pohlenz P,et al.Primary osteoplasty using calvarian bone in patients with cleft lip,alveolus and palate[J].JCraniomaxillofac Surg,2009,37(8):429-433.
[10]Sindetpedersen S,Enemark H.Mandibular bone grafts for reconstruction of alveolar clefts[J].J Oral Maxillofac Surg,1988,46(7):533-537.
[11]Takahashi T,Inai T,Kochi S,et al.Long-term follow-up of dental implants placed in a grafted alveolar cleft:evaluation of alveolar bone height[J].Oral Surg Oral Med Oral Pathol Oral Radiol Endod,2008,105(3):297-302.
[12]Marukawa E,Oshina H,Iino G,et al.Reduction of bone resorption by the application of platelet-rich plasma(PRP)in bone grafting of the alveolar cleft[J].J Craniomaxillofac Surg,2011,39(4):278-283.