骨钉骨膜联合髂骨松质骨植骨术修复替牙期唇腭裂牙槽突裂效果评价

doi:10.19439/j.sjos.2024.04.017

上海口腔医学 ›› 2024, Vol. 33 ›› Issue (4): 426-431.doi: 10.19439/j.sjos.2024.04.017

骨钉骨膜联合髂骨松质骨植骨术修复替牙期唇腭裂牙槽突裂效果评价

唐坤伦, 何晓玲, 陈丹

电子科技大学医学院附属妇女儿童医院·成都市妇女儿童中心医院口腔科,四川成都 610091

收稿日期:2024-02-22 修回日期:2024-03-11 出版日期:2024-08-25 发布日期:2024-09-03
通讯作者: 唐坤伦,E-mail： tang_kl123@163.com
作者简介:唐坤伦（1986-）,男,汉族,硕士,主治医师

Evaluation of the effect of bone nail and artificial periosteum combined with iliac cancellous bone grafting in repairing cleft lip and palate with alveolar cleft during dental replacement

TANG Kun-lun, HE Xiao-ling, CHEN Dan

Department of Stomatology,Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology. Chengdu 610091, Sichuan Province, China

Received:2024-02-22 Revised:2024-03-11 Online:2024-08-25 Published:2024-09-03

摘要/Abstract

摘要： 目的：评价骨钉骨膜联合髂骨松质骨植骨术修复替牙期唇腭裂牙槽突裂的效果。方法：回顾性分析2020年1月—2023年12月收治的62例替牙期唇腭裂牙槽突裂患儿的临床资料,按照术式分为对照组(单纯髂骨松质骨植骨,n=42)和试验组(骨钉骨膜联合髂骨松质骨植骨,n=40)。比较2组植骨区存活骨量体积、移植骨整体和不同植骨区吸收率、植骨成功率、植骨成活率及并发症发生情况。采用SPSS 25.0软件包对数据进行统计学分析。结果：试验组术后3、9个月植骨区存活骨量体积显著大于对照组(P<0.05),且2组术后9个月植骨区存活骨量体积与术后3个月相比差异无统计学意义(P>0.05)。试验组术后3、9个月及3~9个月的移植骨吸收率显著小于对照组(P<0.05),且2组术后9个月移植骨吸收率与3个月相比差异无统计学意义(P>0.05)。试验组术后3、9个月鼻腔侧1/2区、牙槽嵴侧1/2区、唇侧1/2区和腭侧1/2区移植骨吸收率显著低于对照组,且2组牙槽嵴侧1/2区移植骨吸收率显著高于鼻腔侧1/2区,腭侧1/2区显著高于唇侧1/2区(P<0.05)。试验组植骨成功率、植骨成活率显著高于对照组(P<0.05),并发症发生率显著低于对照组(P<0.05)。结论：骨钉骨膜联合髂骨松质骨植骨术可有效修复替牙期唇腭裂牙槽突裂,降低骨吸收率和并发症,提高成骨效果。术后骨量吸收主要发生于术后3个月内,且主要发生于牙槽嵴顶区、腭侧区。

关键词: 骨钉, 骨膜, 髂骨松质骨植骨术, 唇腭裂, 牙槽突裂

Abstract: PURPOSE: To evaluate the effect of bone nail and artificial periosteum combined with iliac cancellous bone grafting in repairing cleft lip and palate with alveolar cleft during dental replacement. METHODS: The clinical data of 82 children with cleft lip and palate with alveolar cleft during dental replacement period were retrospectively analyzed from January 2020 to December 2023, and were divided into control group (iliac cancellous bone grafting alone, n=42) and experimental group (combined iliac cancellous bone grafting with bone nail and artificial periosteum, n=40) according to the operation method. The viable bone volume in bone graft area, absorption rate of whole bone graft and different bone graft areas, success rate of bone graft, survival rate of bone graft and complications were compared between the two groups. SPSS 25.0 software package was used for statistical analysis. RESULTS: The surviving bone volume in the bone graft area was significantly larger in the experimental group 3 and 9 months after operation(P<0.05). There was no significant difference in viable bone volume in bone graft area between the two groups 9 months and 3 months after surgery (P>0.05). The bone graft absorptivity of the experimental group was significantly lower than that of the control group 3, 9 months and 3-9 months after surgery(P<0.05), and there was no significant difference between the two groups at 3, 9 months after surgery(P>0.05). The absorption rate of bone graft in 1/2 area of nasal cavity, 1/2 area of alveolar ridge, 1/2 area of lip and 1/2 area of palate in the experimental group was significantly lower than that in the control group 3 and 9 months after operation(P<0.05). The absorptivity of bone graft in 1/2 area of alveolar ridge was significantly higher than that in 1/2 area of nasal cavity, and the absorptivity of bone graft in 1/2 area of palatal side was significantly higher than that in 1/2 area of lip in both groups (P<0.05). The success rate and survival rate of bone grafting in the experimental group were significantly higher than those in the control group(P<0.05). The complication rate of the experimental group was significantly lower than that of the control group (P<0.05). CONCLUSIONS: Bone nail and artificial periosteum combined with iliac cancellous bone graft can effectively repair cleft lip and palate with alveolar cleft during dental replacement, reduce bone absorption rate and complications, and improve bone formation effect. Meanwhile, postoperative bone mass absorption mainly occurs within 3 months after surgery, and mainly occurs in the alveolar crest area and palatine area.

Key words: Bone nail, Artificial periosteum, Iliac cancellous bone grafting, Cleft lip and palate, Alveolar cleft

中图分类号:

R782.2

唐坤伦, 何晓玲, 陈丹. 骨钉骨膜联合髂骨松质骨植骨术修复替牙期唇腭裂牙槽突裂效果评价[J]. 上海口腔医学, 2024, 33(4): 426-431.

TANG Kun-lun, HE Xiao-ling, CHEN Dan. Evaluation of the effect of bone nail and artificial periosteum combined with iliac cancellous bone grafting in repairing cleft lip and palate with alveolar cleft during dental replacement[J]. Shanghai Journal of Stomatology, 2024, 33(4): 426-431.

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骨钉骨膜联合髂骨松质骨植骨术修复替牙期唇腭裂牙槽突裂效果评价

Evaluation of the effect of bone nail and artificial periosteum combined with iliac cancellous bone grafting in repairing cleft lip and palate with alveolar cleft during dental replacement

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