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数字化外科技术辅助下的块状骨移植治疗牙槽嵴裂的临床研究(1)
http://www.100md.com 2018年5月1日 《中国美容医学》 2018年第9期
     [摘要]目的:探究数字化外科技术辅助下的块状骨移植治疗牙槽嵴裂的可行性。方法:选择2016年1月-2017年11月笔者科室收治的64例接受过唇裂、腭裂修复的单侧完全性牙槽嵴裂患者,分别接受数字化外科技术辅助下的块状骨移植和传统的泥沙状骨移植修复牙槽嵴裂,对比两组患者的临床效果。结果:术后6个月时,研究组的植骨成活率为93.75%,而对照组仅为87.5%,差异不具有统计学意义(P>0.05)。两组患者术后的骨剩余量呈现逐渐减少的趋势,且术后1个月、3个月、6个月时,研究组的骨吸收量均明显低于对照组,具有统计学差异(P<0.05)。结论:对于牙槽嵴裂的治疗,相比传统的治疗方法,使用数字化外科技术辅助下的块状骨移植治疗可显著减少骨量的吸收,提高植骨的成活,为后续的牙列正畸或种植义齿打下良好的基础,值得临床推广使用。

    [关键词]数字化外科技术;块状骨移植;泥沙状骨移植;牙槽嵴裂;植骨成活率

    [中图分类号]R782.2+4 [文献标志码]A [文章编号]1008-6455(2018)09-0084-04
, 百拇医药
    Clinical Study on Massive Bone Graft in the Treatment of Alveolar Cleft by Digital Surgical Technique

    ZHANG Yan-sheng,YU Lan,WANG Juan,ZHAO Shi-jun,SHI Bing-zheng,LIANG Liang

    (Department of Stomatology, Cangzhou People's Hospital, Cangzhou 061000, Hebei,China)

    Abstract: Objective To explore feasibility study of massive bone graft in the treatment of alveolar cleft by digital surgical technique. Methods The hospital selected 64 patients with unilateral complete cleft alveolar cleft who underwent cleft lip and palate repair from January 2016 to November 2017 . Digital bone grafting and traditional bone grafting were used to repair alveolar cleft, relatively. The clinical effects of the two groups were compared. Results At 6 months after operation, the survival rate of bone graft in the study group was 93.75%, while that in the control group was only 87.5%, and the difference was not statistically significant (P>0.05). The bone surplus of the two groups showed a tendency to decrease gradually, and the amount of bone absorption in the study group was significantly lower than that of the control group in January, March after operation and June after the operation, with a statistically significant difference (P<0.05). Conclusion For the treatment of alveolar cleft, compared with the traditional treatment method, the use of digital surgery assisted lump bone transplantation can significantly reduce the absorption of bone mass, which is beneficial to the survival of bone graft, and lay a good foundation for subsequent dentition orthodontic or implant denture, which is worthy of the use.
, 百拇医药
    Key words: digital surgical technique; massive bone graft; sand bone graft; alveolar cleft; bone graft survival rate

    牙槽嵴裂屬于常见的先天性畸形疾病,在我国的发生率约为1.7‰,由于牙槽嵴骨的缺损,导致牙弓失去完整性,从而导致在裂隙处牙齿难以萌出,在缺损处牙齿会发生异位萌出,常合并出现鼻瘘、鼻翼塌陷畸形等[1-2]。牙槽嵴裂的治疗必须依靠手术方法矫正,经过多年的临床探索,治疗方式已从早期简单的关闭唇牙槽嵴裂隙,发展到正规的序贯治疗,即包括正畸手术、修复矫形、修复牙槽骨缺损、正颌手术治疗、耳鼻喉科联合治疗及语音训练联同心理治疗等综合治疗方法,可显著提高患者的手术效果及远期预后,已广泛应用于临床[3]。序贯治疗中牙槽嵴裂植骨术是最为重要的环节,可在恢复牙弓完整性的基础上,提高上颌骨的稳定性,从而对于后续牙列正畸、种植义齿、鼻翼矫形等治疗提供解剖结构上的支持。传统的牙槽嵴裂植骨术通过取髂前上嵴的松质骨剪碎成泥沙状再行移植填补裂隙,虽取得了一定的治疗效果,但是通过远期跟踪随访发现其植骨效果并不理想,一方面植骨成活率有待提高,另一方面相当一部分植骨成活的病例后期骨吸收过多,均需要行二次植骨术,所以临床上开始不断探索新的治疗手段[4-5]。有文献报道[6-7],利用新型数字化外科技术可有助于利用重塑的块状骨移植治疗牙槽嵴裂,有助于提高植骨的成活。故笔者科室选择2016年1月-2017年11月收治的64例接受过唇裂、腭裂修复的单侧完全性牙槽嵴裂患者作为研究对象,探究数字化外科技术辅助下的块状骨移植治疗牙槽嵴裂的临床研究,现将结果报道如下。, 百拇医药(张彦升 于兰 王娟 赵世俊 时炳正 梁亮)
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