口腔修复膜和β-磷酸三钙治疗颌骨囊肿术后骨缺损的临床价值

doi:10.7518/hxkq.2020.05.012

华西口腔医学杂志 ›› 2020, Vol. 38 ›› Issue (5): 541-545.doi: 10.7518/hxkq.2020.05.012

口腔修复膜和β-磷酸三钙治疗颌骨囊肿术后骨缺损的临床价值

胡爽¹(), 李春梅¹, 张帅源¹, 秦硕¹, 解晨露², 牛志兴¹, 孙明磊¹()

^1. 郑州大学第一附属医院口腔颌面外科,郑州 450052
^2. 南方医院增城分院口腔科,广州 510515

收稿日期:2019-12-27 修回日期:2020-07-19 出版日期:2020-10-01 发布日期:2020-10-14
通讯作者: 孙明磊 E-mail:570789290@qq.com;mlsun@zzu.edu.cn
作者简介:胡爽,住院医师,硕士,E-mail：570789290@qq.com
基金资助:
郑州市口腔颌面外科院士工作站项目(152PYSGZ040);河南省教育厅一般项目(13A320452)

Clinical value of oral repair membrane and β-tricalcium phosphate in the treatment of the postoperative bone defect of jaw cyst

Hu Shuang¹(), Li Chunmei¹, Zhang Shuaiyuan¹, Qin Shuo¹, Xie Chenlu², Niu Zhixing¹, Sun Minglei¹()

^1. Dept. of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
^2. Dept. of Stomatology, Zengcheng Branch of Southern Hospital, Guangzhou 510515, China

Received:2019-12-27 Revised:2020-07-19 Online:2020-10-01 Published:2020-10-14
Contact: Sun Minglei E-mail:570789290@qq.com;mlsun@zzu.edu.cn

摘要/Abstract

摘要： 目的探讨口腔修复膜和β-磷酸三钙（β-TCP）在颌骨囊肿术后骨缺损修复中的临床效果。方法对81例颌骨囊肿病例进行回顾性分析,收集临床资料,比较传统手术刮治（A组,27例）、刮治后放置修复膜覆盖创面（B组,27例）和刮治后放置骨粉充填骨缺损并覆盖修复膜（C组,27例）3种治疗方式的疗效。结果 81例患者术后均无复发。3组患者术前CT值差异无统计学意义（P<0.05）;术后3、6、12个月复查CT,3组CT值间差异具有统计学意义（P<0.05）,C组优于B组和A组（P<0.05）。结论相对于传统的颌骨囊肿刮治疗法,应用修复膜具有较好的成骨效果,联合应用β-TCP和修复膜可获得更佳的疗效。

关键词: 修复膜, β-磷酸三钙;, 锥形束CT, 颌骨囊肿, 骨缺损

Abstract:

Objective This study aims to evaluate the clinical effect of oral repair membrane and β-tricalcium phosphate (β-TCP) on the treatment of jaw cyst. Methods A retrospective analysis was performed on 81 cases of jaw cysts, and clinical data were collected for the comparison of traditional surgical curettage (group A, 27 cases), biofilm covering bone wounds after curettage (group B, 27 cases), and β-TCP filling combined with biofilm covering. Results No recurrence occurred in 81 patients, and no significant difference in preoperative CT value among the three groups (P<0.05). Follow-up CT reexamination 3, 6, and 12 months after operation showed significant differences among the three groups of CT values (P<0.05). Group C was better than Group B or Group A (P<0.05). Conclusion In traditional jaw cyst curettage, the application of biofilm exhibited good osteogenesis effect, and the combined application of β-TCP and biofilm exerted a better effect.

Key words: repair membrane, β-tricalcium phosphate, cone beam computed tomography, jaw cyst, bone defect

中图分类号:

R739.8

胡爽, 李春梅, 张帅源, 秦硕, 解晨露, 牛志兴, 孙明磊. 口腔修复膜和β-磷酸三钙治疗颌骨囊肿术后骨缺损的临床价值[J]. 华西口腔医学杂志, 2020, 38(5): 541-545.

Hu Shuang, Li Chunmei, Zhang Shuaiyuan, Qin Shuo, Xie Chenlu, Niu Zhixing, Sun Minglei. Clinical value of oral repair membrane and β-tricalcium phosphate in the treatment of the postoperative bone defect of jaw cyst[J]. West China Journal of Stomatology, 2020, 38(5): 541-545.

图/表 3

参考文献 21

[1]	Jones AV, Franklin CD . An analysis of oral and maxillofacial pathology found in adults over a 30-year period[J]. J Oral Pathol Med, 2006,35(7):392-401. doi: 10.1111/j.1600-0714.2006.00451.x URL pmid: 16827841
[2]	Donoff B . Manual of oral and maxillofacial surgery[M]. St.Lois: Mosby Co, 1987.
[3]	Morgan TA, Burton CC, Qian F . A retrospective review of treatment of the odontogenic keratocyst[J]. J Oral Maxillofac Surg, 2005,63(5):635-639. doi: 10.1016/j.joms.2004.07.026 URL pmid: 15883937
[4]	Zhao YF, Wei JX, Wang SP . Treatment of odontogenic keratocysts: a follow-up of 255 Chinese patients[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2002,94(2):151-156. doi: 10.1067/moe.2001.125694 URL pmid: 12221380
[5]	周健, 杜若鸿 . 颌骨囊肿的治疗方法及其临床应用[J]. 口腔颌面外科杂志, 2012,22(4):229-232. doi: 10.3969/j.issn.1005-4979.2012.04.001 URL
	Zhou J, Du RH . Assessment on the treatments for cyst of the jaws[J]. J Oral Maxillofac Surg, 2012,22(4):229-232.
[6]	张志愿 . 口腔颌面外科学[M]. 7版. 北京: 人民卫生出版社, 2012: 177-184.
	Zhang ZY. Oral and maxillofacial surgery[M]. 7th ed. Beijing: People’s Medical Publishing House, 2012: 177-184.
[7]	Chacko R, Kumar S, Paul A , et al. Spontaneous bone regeneration after enucleation of large jaw cysts: a digital radiographic analysis of 44 consecutive cases[J]. J Clin Diagn Res, 2015, 9(9): ZC84-ZC89. doi: 10.7860/JCDR/2015/13394.6524 URL pmid: 26501020
[8]	郭骏, 黄怡, 费伟 , 等. 颌骨囊肿开窗减压术与刮治术临床疗效评价及应用分析[J]. 口腔颌面外科杂志, 2018,28(4):219-224.
	Guo J, Huang Y, Fei W , et al. Clinical evaluation and application analysis of fenestration decompression and curettage for jaw cysts[J]. J Oral Maxillofac Surg, 2018,28(4):219-224.
[9]	Chiapasco M, Rossi A, Motta JJ , et al. Spontaneous bone regeneration after enucleation of large mandibular cysts: a radiographic computed analysis of 27 consecutive cases[J]. J Oral Maxillofac Surg, 2000,58(9):942-949. doi: 10.1053/joms.2000.8732 URL pmid: 10981973
[10]	Pichotano EC, de Molon RS, Freitas de Paula LG , et al. Early placement of dental implants in maxillary sinus grafted with leukocyte and platelet-rich fibrin and deproteinized bovine bone mineral[J]. J Oral Implantol, 2018,44(3):199-206. doi: 10.1563/aaid-joi-D-17-00220 URL pmid: 29457934
[11]	Diana C, Mohanty S, Chaudhary Z , et al. Does platelet-rich fibrin have a role in osseointegration of immediate implants? A randomized, single-blind, controlled clinical trial[J]. Int J Oral Maxillofac Surg, 2018,47(9):1178-1188. doi: 10.1016/j.ijom.2018.01.001 URL pmid: 29402513
[12]	Chenchev IL, Ivanova VV, Neychev DZ , et al. Application of platelet-rich fibrin and injectable platelet-rich fibrin in combination of bone substitute material for alveolar ridge augmentation-a case report[J]. Folia Med (Plovdiv), 2017,59(3):362-366.
[13]	Khan ZA, Jhingran R, Bains VK , et al. Evaluation of peri-implant tissues around nanopore surface implants with or without platelet rich fibrin: a clinico-radiographic study[J]. Biomed Mater, 2018,13(2):025002. doi: 10.1088/1748-605X/aa8fa3 URL pmid: 28956535
[14]	Shah R, Thomas R, Mehta DS . An update on the protocols and biologic actions of platelet rich fibrin in dentistry[J]. Eur J Prosthodont Restor Dent, 2017,25(2):64-72. doi: 10.1922/EJPRD_01690Shah09 URL pmid: 28590091
[15]	Akram M, Farooqi FM, Shahzad ML , et al. A comparison of treating Unicameral bone cyst using steroids and percutaneous autologous bone marrow aspiration injection[J]. J Pak Med Assoc, 2015,65(11 Suppl 3):S156-S159. URL pmid: 26878509
[16]	Deyhimi P, Razavi SM, Shahnaseri S , et al. Rare and extensive malignant melanoma of the oral cavity: report of two cases[J]. J Dent (Shiraz), 2017,18(3):227-233.
[17]	Liu Q, Cen L, Yin S , et al. A comparative study of proliferation and osteogenic differentiation of adipose-derived stem cells on akermanite and beta-TCP ceramics[J]. Biomaterials, 2008,29(36):4792-4799. doi: 10.1016/j.biomaterials.2008.08.039 URL
[18]	Xu S, Li D, Xie Y , et al. The growth of stem cells within β-TCP scaffolds in a fluid-dynamic environment[J]. Mater Sci Eng: C, 2008,28(1):164-170. doi: 10.1016/j.msec.2007.09.003 URL
[19]	Hoshino M, Egi T, Terai H , et al. Repair of long intercalated rib defects using porous beta-tricalcium phosphate cylinders containing recombinant human bone morphogenetic protein-2 in dogs[J]. Biomaterials, 2006,27(28):4934-4940. doi: 10.1016/j.biomaterials.2006.04.044 URL
[20]	Brown EM . Is the calcium receptor a molecular target for the actions of strontium on bone[J]. Osteoporos Int, 2003, ( 14 Suppl 3):S25-S34.
[21]	Zhao Y, Liu B, Han QB , et al. Changes in bone density and cyst volume after marsupialization of mandibular odontogenic keratocysts (keratocystic odontogenic tumors)[J]. J Oral Maxillofac Surg, 2011,69(5):1361-1366. doi: 10.1016/j.joms.2010.05.067 URL pmid: 21195525

组别	术前	术后3个月	术后6个月	术后12个月
A组	48.9±13.2	97.3±10.1	122.0±1.8	157.8±18.3
B组	48.4±13.8	125.8±9.5^#	195.3±15.1^#	281.2±23.8^#
C组	47.6±14.2	397.8±14.8*^△	602.6±13.5*^△	579.6±99.9*^△

口腔修复膜和β-磷酸三钙治疗颌骨囊肿术后骨缺损的临床价值

Clinical value of oral repair membrane and β-tricalcium phosphate in the treatment of the postoperative bone defect of jaw cyst

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