自体碎骨结合Bio-OSS骨粉修复颌骨囊肿术后骨缺损疗效观察

向国昌 蹇雪春

[摘要]目的：观察自体碎骨结合Bio-OSS骨粉修复颌骨囊肿术后骨缺损的效果。方法：纳入2015年1月-2019年1月笔者医院收治的160例颌骨囊肿术后骨缺损患者为研究对象，采用随机数字表法分为观察组和对照组，每组80例。对照组患者采用Bio-OSS骨粉修复，观察组采用自体碎骨结合Bio-OSS骨粉修复。比较两组患者切口愈合情况，术前及术后不同阶段（术后3个月、术后6个月）植骨区骨密度值，骨吸收量（垂直骨吸收量、舌侧骨吸收量），以及附着丧失变化情况。结果：观察组患者术后切口愈合情况优于对照组（P<0.05）;观察组患者术后3個月、6个月植骨区骨密度值均高于对照组（P<0.05）;观察组患者术后3个月、6个月垂直骨吸收量、舌侧骨吸收量均小于对照组（P<0.05）;两组患者术后3个月附着丧失均较术前显著降低，术后6个月较术后3个月持续降低，两组比较差异均有统计学意义（P<0.05）。结论：自体碎骨结合Bio-OSS骨粉修复颌骨囊肿术后骨缺损可利于创口愈合，减少骨吸收，疗效显著。

[关键词]自体碎骨;Bio-OSS骨粉;颌骨囊肿术后;骨缺损;修复效果

[中图分类号]R139.81    [文献标志码]A    [文章编号]1008-6455（2021）04-0055-03

Observation on Effects of Autologous Bone Fragmentation Combined with Bio-OSS Bone Meal in Repairing Bone Defects after Jaw Cyst Surgery

XIANG Guo-chang， JIAN Xue-chun

（Department of Maxillofacial Surgery， Three Gorges Hospital， Chongqing University， Chongqing 404000， China）

Abstract：Objective To observe the effects of autologous bone fragmentation combined with Bio-OSS bone meal in repairing bone defects after jaw cyst surgery. Methods  A total of 160 patients with bone defects after jaw cyst surgery in our hospital from January 2015 to January 2019 were included as research subjects， and they were divided intoobservation group and control groupaccording to the random number table method， with 80 cases in each group. The patients in control group were repaired with Bio-OSS bone meal，and the patients in observation groupwere repaired with autologous bone fragmentation and Bio-OSS bone meal.Incision healing， and bone mineral density and bone absorption volume （vertical bone absorption， lingual bone absorption） in bone grafting area before surgery andat different stages after surgery （at 3 months and 6 months after surgery） and attachment loss were compared between the two groups. Results The postoperative incision healing in observation group was better than that in control group （P<0.05）.The bone mineral density values in bone grafting area in observation group at 3 months and 6 months after surgery were higher than those in control group （P<0.05）. The vertical bone absorption and lingual bone absorption at 3 months and 6 months after surgery in observation group were smaller than those in control group （P<0.05）.The attachment loss in the two groups at 3 months after surgery was significantly lower than that before surgery， and the attachment lossat 6 months after surgery continued to decrease compared with that at 3 months after surgery， and the differences between the two groups were statistically significant （P<0.05）. Conclusion In repairing bone defects after jaw cyst surgery， autogenous bone fragmentation combined with Bio-OSS bone meal is conducive to wound healing， and it can reduce bone absorption， and has a significant efficacy.

Key words： autologous bone fragmentation; Bio-OSS bone meal; after jaw cyst surgery; bone defects; repair effects

颌骨囊肿是一种发病率较高的口腔颌面外科疾病，该疾病临床症状不明显，且发病隐匿，早期囊肿较小，无明显不适感，故难以及时发现和就诊。许多患者确诊时已出现严重的骨质损害，甚至已形成咬合紊乱、牙齿移位、牙龈凹痕，此时病变已破坏周围颌骨组织，严重者可导致颌骨形态改变甚至颌面部畸形，严重影响患者生活质量[1]。临床治疗主要采取囊肿摘除术、颌骨部分切除术等手段，术后形成较大无效腔，虽然人体自身骨有一定的自我修复再生能力，但骨缺损一旦达到一定范围，则很难自行恢复至原本的骨性构造[2]。目前，临床采取植入生物材料或植骨的方式修复无效腔。本研究采用自体碎骨结合Bio-OSS骨粉修复颌骨囊肿术后骨缺损，取得了满意疗效，现将结果报道如下。……