骨修复材料在颌骨囊肿术后骨缺损修复中的应用(1)
[摘要]目的：将骨修复材料(Osteobone)运用于颌骨囊肿术后残留骨缺损区，观察其成骨的效果。方法：选择苏州大学附属第一医院口腔科2016年11月-2017年3月行手术治疗的30例颌骨囊肿患者，术中在骨缺损区植入骨修复材料，术后1、3、6个月复查，通过口腔专科检查及影像学检查对其成骨效果进行评估。结果：30例患者，2例出现创口裂开，植入物溢出，手术切口优良愈合率为93.3%。对其余28例患者进行影像学监测，术后1个月均有新骨形成，骨愈合率为51.80%，术后3个月骨愈合率为79.50%，术后6个月骨愈合率为91.10%，有3例囊肿直径>6cm的病例，骨形成占骨缺损的21%～40%。随着时间的推移，骨愈合率呈上升趋势，骨缺损修复所需要的时间与骨缺损的大小有关。结论：骨修复材料在颌骨囊肿导致的骨缺损病例中具有较好的成骨效果，可单独运用于临床。
[关键词]颌骨囊肿;骨修复材料;骨缺损;手术;放射学;成骨
[中图分类号]R139.81 [文献标志码]A [文章编号]1008-6455(2019)03-0104-05
Abstract： Objective To observe the osteogenic effect of Osteobone bone repair materials graft in the repair of bone defects in jaw cyst. Methods Thirty jaw cyst patients were enrolled from the Department of Stomatology in The First Affiliated Hospital of Soochow University between November 2016 and March 2017.The Jaw cyst was scraped and Osteobone bone repair materials implanted in the bone cavity. All cases were followed-up for 1，3，6 months， according to the clinical observation and radiological examination. The effect of the treatment was evaluated. Results In the 30 cases of patients，there were only two patients had wound exudation after operation， less of the bone repair materials were flushed. The incision healing rate was 93.3%. Through the Radiology to monitor the other 28 patients， At 1 month after operation， there were new bone formation， bone healing rate was 51.80%. At 3 months after operation， the bone healing rate was 79.50%. At 6 months after operation， the bone healing rate was 91.10%. There were 3 cases with cyst diameter greater than 6cm， bone formation accounting for 21%-40% of bone defect. As time goes on， the rate of bone healing increased， and the time required to repair the bone defect was related to the size of the bone defect. Conclusion Osteobone bone repair materials with quite good osteogenesis and bone reconstructed ability，has the feasibility to clinical application.
Key words： jaw cyst; bone repair material; bone defect; operation; radiology; osteogenesis
頜骨囊肿的发生率在口腔颌面外科常见病中位居第二[1]，包括牙源性颌骨囊肿及发育性颌骨囊肿，常见的是牙源性颌骨囊肿，约占颌骨囊肿的90%，是一类来源于成牙组织，牙的上皮或上皮剩余，在口腔颌骨任何部位均可发病的囊性病损。主要包括根尖周囊肿、含牙囊肿、始基囊肿、牙源性角化囊肿等。囊肿生长速度缓慢，早期多无明显症状，对于小的根尖周囊肿，常采用非手术治疗，通过完善的根管治疗，囊肿即可逐渐骨化、消失。如未给予干预，随着病情的进展，囊腔呈离心性膨胀，表面骨质破坏吸收成薄壁，临床检查触诊可扪及乒乓球感，则需行手术治疗，终止病情进展。体积较大的囊肿手术后残留较大骨死腔，易并发感染、创口愈合不良、术创区软组织塌陷及病理性骨折等并发症，因此，在确保完整摘除囊肿，刮净囊壁，终止病变的前提下，快速有效地修复骨质缺损，恢复颌骨的完整性，较快达到骨愈合，是口腔颌面外科医生关注的重点。消灭骨死腔的方法主要有血块移植法、碟形手术、囊腔植骨术、生物材料植入等，传统的自体骨移植、同种异体骨移植及异种骨移植均存在一定的缺陷。近年来，随着材料学的发展，人工合成生物材料的应用已成为骨缺损修复的研究热点。本研究就笔者科室选取的30例牙源性颌骨囊肿摘除术后植入骨修复材料充填骨缺损腔治疗的临床预后进行跟踪观察，取得了较理想的效果，并对结果进行分析，现报道如下。, http://www.100md.com(张佩莹 肖灿)
[关键词]颌骨囊肿;骨修复材料;骨缺损;手术;放射学;成骨
[中图分类号]R139.81 [文献标志码]A [文章编号]1008-6455(2019)03-0104-05
Abstract： Objective To observe the osteogenic effect of Osteobone bone repair materials graft in the repair of bone defects in jaw cyst. Methods Thirty jaw cyst patients were enrolled from the Department of Stomatology in The First Affiliated Hospital of Soochow University between November 2016 and March 2017.The Jaw cyst was scraped and Osteobone bone repair materials implanted in the bone cavity. All cases were followed-up for 1，3，6 months， according to the clinical observation and radiological examination. The effect of the treatment was evaluated. Results In the 30 cases of patients，there were only two patients had wound exudation after operation， less of the bone repair materials were flushed. The incision healing rate was 93.3%. Through the Radiology to monitor the other 28 patients， At 1 month after operation， there were new bone formation， bone healing rate was 51.80%. At 3 months after operation， the bone healing rate was 79.50%. At 6 months after operation， the bone healing rate was 91.10%. There were 3 cases with cyst diameter greater than 6cm， bone formation accounting for 21%-40% of bone defect. As time goes on， the rate of bone healing increased， and the time required to repair the bone defect was related to the size of the bone defect. Conclusion Osteobone bone repair materials with quite good osteogenesis and bone reconstructed ability，has the feasibility to clinical application.
Key words： jaw cyst; bone repair material; bone defect; operation; radiology; osteogenesis
頜骨囊肿的发生率在口腔颌面外科常见病中位居第二[1]，包括牙源性颌骨囊肿及发育性颌骨囊肿，常见的是牙源性颌骨囊肿，约占颌骨囊肿的90%，是一类来源于成牙组织，牙的上皮或上皮剩余，在口腔颌骨任何部位均可发病的囊性病损。主要包括根尖周囊肿、含牙囊肿、始基囊肿、牙源性角化囊肿等。囊肿生长速度缓慢，早期多无明显症状，对于小的根尖周囊肿，常采用非手术治疗，通过完善的根管治疗，囊肿即可逐渐骨化、消失。如未给予干预，随着病情的进展，囊腔呈离心性膨胀，表面骨质破坏吸收成薄壁，临床检查触诊可扪及乒乓球感，则需行手术治疗，终止病情进展。体积较大的囊肿手术后残留较大骨死腔，易并发感染、创口愈合不良、术创区软组织塌陷及病理性骨折等并发症，因此，在确保完整摘除囊肿，刮净囊壁，终止病变的前提下，快速有效地修复骨质缺损，恢复颌骨的完整性，较快达到骨愈合，是口腔颌面外科医生关注的重点。消灭骨死腔的方法主要有血块移植法、碟形手术、囊腔植骨术、生物材料植入等，传统的自体骨移植、同种异体骨移植及异种骨移植均存在一定的缺陷。近年来，随着材料学的发展，人工合成生物材料的应用已成为骨缺损修复的研究热点。本研究就笔者科室选取的30例牙源性颌骨囊肿摘除术后植入骨修复材料充填骨缺损腔治疗的临床预后进行跟踪观察，取得了较理想的效果，并对结果进行分析，现报道如下。, http://www.100md.com(张佩莹 肖灿)