摘要
目的·探索黏性骨[脱蛋白猪骨矿物颗粒联合高级富血小板纤维蛋白(advanced platelet-rich fibrin,A-PRF)与液态富血小板纤维蛋白(liquid platelet-rich fibrin,L-PRF)]在单侧牙槽突裂修复中的临床效果和安全性。方法·招募2023年12月1日—2024年8月31日确诊为单侧牙槽突裂且符合纳入标准的患者。将患者随机分为2组,分别采用黏性骨或自体髂骨松质骨移植进行牙槽突裂植骨术,黏性骨组设为试验组,髂骨组设为对照组。主要疗效指标为术后6个月的骨吸收率,通过收集患者术前、术后即刻及术后半年的计算机断层扫描数据,利用Simplant Pro 17.01软件测量术后即刻与术后半年的移植骨量以计算该指标。次要疗效指标包括术后6个月的骨密度、患者术后并发症发生情况以及口腔健康质量量表得分。运用Prism 10软件进行数据分析,采用t检验及Pearson相关性分析方法。结果·试验组纳入17名单侧牙槽突裂患者,对照组纳入15名患者。试验组术后6个月剩余骨量多于对照组,试验组骨吸收率为33.24%±17.16%,显著低于对照组的66.31%±17.98%(P<0.001)。试验组有1名患者在术后2周出现前庭侧黏膜裂开,并伴有骨粉排出;对照组有3名患者在术后1个月出现前庭侧黏膜裂开伴松质骨排出,其中1名患者在术后4个月出现移植骨坏死。试验组术后6个月骨密度显著高于对照组(P<0.001),且口腔健康质量量表得分更低。结论·相较于髂骨松质骨,黏性骨用于单侧牙槽突裂患者的治疗时,展现出更低的骨吸收率与更高的骨密度,表明其成骨能力更佳。较少的并发症例数与更低的口腔健康量表得分,提示其安全性更高,因而具有较好的临床推广应用价值。
Objective·To explore the clinical efficacy and safety of sticky bone[deproteinized porcine bone mineral granules combined with advanced platelet-rich fibrin(A-PRF)and liquid platelet-rich fibrin(L-PRF)]in the repair of unilateral alveolar cleft.Methods·Patients diagnosed with unilateral alveolar cleft who met the inclusion and exclusion criteria were recruited from December 1,2023 to August 31,2024.The patients were randomly divided into 2 groups.The experimental group received sticky bone grafts,and the control group received autologous iliac cancellous bone grafts for alveolar cleft repair.The primary efficacy index was the bone resorption rate at 6 months post-surgery,calculated by measuring the grafted bone volume immediately after surgery and at 6 months using Simplant Pro 17.01 software based on patients'computed tomography data collected before surgery,immediately after surgery,and 6 months post-surgery.Secondary efficacy indices included bone density at 6 months after surgery,the occurrence of postoperative complications in patients,and the scores on the oral health-related quality of life scale.Prism 10 software was used for data analysis,and t-test and Pearson correlation analysis methods were adopted.Results·Seventeen patients with unilateral alveolar cleft were included in the experimental group,and 15 in the control group.The remaining bone volume in the experimental group at 6 months after surgery was more than that in the control group.The bone resorption rate in the experimental group was 33.24%±17.16%,significantly lower than 66.31%±17.98%in the control group(P<0.001).One patient in the experimental group had vestibular mucosal dehiscence accompanied by bone powder discharge 2 weeks after surgery;3 patients in the control group had vestibular mucosal dehiscence accompanied by cancellous bone discharge 1 month after surgery,with one case of grafted bone necrosis 4 months after surgery.The bone density in the experimental group at 6 months after surgery was significantly higher than that in the control group(P<0.001),and the scores on the oral health-related quality of life scale were lower.Conclusion·Compared with iliac cancellous bone,when sticky bone is used in the treatment of patients with unilateral alveolar cleft,it shows a lower bone resorption rate and higher bone density,indicating better osteogenic ability.Fewer number of complications and lower scores on the oral health-related quality of life scale suggest greater safety,thereby supporting its strong potential for clinical promotion and application.
作者
虞祖音
刘逸云
解嘉慧
蔡鸣
沈国芳
YU Zuyin;LIU Yiyun;XIE Jiahui;CAI Ming;SHEN Guofang(Department of Oral and Maxillofacial Surgery,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,College of Stomatology,Shanghai Jiao Tong University,National Center for Stomatology,National Clinical Research Center for Oral Diseases,Shanghai Key Laboratory of Stomatology,Shanghai Research Institute of Stomatology,Shanghai 200011,China)
出处
《上海交通大学学报(医学版)》
北大核心
2025年第8期1017-1026,共10页
Journal of Shanghai Jiao tong University:Medical Science
基金
上海市重中之重研究中心项目(NCRCO202328)
上海交通大学医疗机器人研究院-第九人民医院临床联合研究中心项目(IMR-NPH202003)
上海市科委地方院校能力建设项目(22010502600)。
关键词
单侧牙槽突裂
黏性骨
骨吸收率
骨密度
口腔健康质量
植骨术
unilateral alveolar cleft
sticky bone
bone resorption rate
bone mineral density
oral health quality
bone grafting surgery
