上海口腔医学 ›› 2025, Vol. 34 ›› Issue (5): 530-534.doi: 10.19439/j.sjos.2025.05.014

• 论著 • 上一篇    下一篇

明胶海绵与羟基磷灰石生物陶瓷在根尖切除骨缺损修复中的疗效比较

拓瑞1, 周谦1, 呼延静2, 田莹3   

  1. 1.延安大学附属医院 口腔颌面外科,2.麻醉科,3.牙周病科,陕西 延安 716000
  • 收稿日期:2024-11-04 修回日期:2024-12-18 出版日期:2025-10-25 发布日期:2025-10-31
  • 通讯作者: 周谦,E-mail:zhouqian08@163.com
  • 作者简介:拓瑞(1989-),男,本科,主治医师,E-mail:tarui091l@163.com
  • 基金资助:
    陕西省自然科学基础研究计划项目(2020JQ-563)

Comparison of the efficacy of gelatin sponge and hydroxyapatite bioceramics in the repair of bone defect in apicectomy

Tuo Rui1, Zhou Qian1, Hu Yanjing2, Tian Ying3   

  1. 1. Department of Oral and Maxillofacial Surgery, 2.Department of Anesthesiology, 3.Department of Periodontology, Yan'an University Affiliated Hospital. Yan'an 716000, Shaanxi Province, China
  • Received:2024-11-04 Revised:2024-12-18 Online:2025-10-25 Published:2025-10-31

摘要: 目的:评估和比较明胶海绵与羟基磷灰石生物陶瓷(hydroxyapatite ceramic,HA)在根尖切除后骨缺损修复中的临床疗效及生物相容性。方法:选择2020年1月—2024年1月收治的187例根尖囊肿患者,采用随机数字表法分为明胶海绵组(93例)和HA组(94例)。2组患者均行根尖切除术,明胶海绵组采用明胶海绵充填,HA组采用羟基磷灰石生物陶瓷修复。统计并比较两组患者术前及术后2周实验室指标,两组治疗后6个月植骨高度、厚度和骨生长效果,以及两组术后愈合情况及不良反应发生情况。结果:HA组植骨高度、植骨厚度和新生骨密度显著高于明胶海绵组(P<0.05)。术后HA组白细胞计数、中性粒细胞比例、C反应蛋白、红细胞沉降率和血清肌酐水平均显著低于明胶海绵组(P<0.05)。术后HA组丙氨酸氨基转移酶、天门冬氨酸氨基转移酶水平显著高于明胶海绵组(P<0.05)。HA组治疗有效率为100.00%,显著高于明胶海绵组的95.70%(P<0.05)。HA组不良反应发生率为4.26%,显著低于明胶海绵组的12.90%(P<0.05)。结论:羟基磷灰石生物陶瓷在根尖切除后骨缺损修复中表现出比明胶海绵更优的修复效果和生物相容性,可能是一种更有效的骨修复材料,特别是在促进新生骨形成和减少术后并发症方面。

关键词: 根尖切除术, 明胶海绵, 羟基磷灰石生物陶瓷, 骨缺损修复, 临床疗效, 生物相容性

Abstract: PURPOSE: To evaluate and compare the clinical efficacy and biocompatibility of gelatin sponge and hydroxyapatite bioceramic in the repair of bone defects in apicectomy. METHODS: A total of 187 patients with periapical cysts treated from January 2020 to January 2024 were selected and randomly divided into two groups using a random number table method: gelatin sponge group(n=93) and hydroxyapatite ceramic (HA) group(n=94). Apicectomy was performed in both groups, gelatin sponge group was filled with gelatin sponge, HA group was repaired with hydroxyapatite bioceramics.Preoperative and two-week postoperative laboratory indicators were statistically analyzed and compared between the two groups. Additionally, the bone graft height, thickness and bone growth outcomes were compared six months after treatment. The postoperative healing and occurrence of adverse reactions were also compared between the two groups. RESULTS: The bone graft height, bone graft thickness and new bone density in HA group were significantly higher than those of the gelatin sponge group(P<0.05). The levels of white blood cell count (WBC), neutrophil ratio (NEU), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and serum creatinine (SCR) in HA group were significantly lower than those of the gelatin sponge group(P<0.05). The levels of alanine aminotransferase (ALT) and aspartate aminotransferase(AST) in HA group were significantly higher than those in the gelatin sponge group(P<0.05). The effective rate of HA group was 100.00%, which was significantly higher than that of the gelatin sponge group (95.70%, P<0.05). The incidence of adverse reactions in HA group was 4.26%, which was significantly lower than 12.90% in the gelatin sponge group (P<0.05). CONCLUSIONS: Hydroxyapatite bioceramics shows better repairing effect and biocompatibility than gelatin sponges in bone defect repair after apicectomy. Hydroxyapatite bioceramics may be a more effective bone repair material, especially in promoting new bone formation and reducing postoperative complications.

Key words: Apicectomy, Gelatin sponge, Hydroxyapatite bioceramics, Bone defect repair, Clinical efficacy, Biocompatibility

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