膜引导组织再生技术联合自体骨移植在下颌骨缺损中的临床研究

Clinical application of combined guided tissue regeneration with autogenic bone transplantation in mandibular defects

目的评价膜引导组织再生技术(GTR)联合自体骨移植在重建下颌骨的完整性,恢复下颌骨、口腔的功能,矫正颌面部畸形中的应用效果。方法应用GTR技术联合自体游离髂骨,按缺损区设计切取一定长度和形状的自体游离髂骨,经剪磨削成颗粒,植入下颌骨缺损区,上以胶原膜覆盖,用细丝线缝合固定膜后,加压包扎。并观察切口愈合、骨生长情况、X线检查的临床效果。结果7例患者术后切口均Ⅰ期愈合,骨生长情况良好,缺损处覆盖完全,达到骨整合的效果。结论膜引导组织再生技术在修复下颌骨缺损中显示了较高的临床应用价值。

Objective To estimate the effect of the combined clinical application of guided tissue regeneration （GTR） with autologous bone transplantation oft the mandibular reconstruction, aiming to re-establish the mandibular and oral function and correct the maxillofacial defect. Methods The technique of GTR combined with transplantation of autologous iliac bone was applied in the treatment of 7 patients with mandibular defects starting in September 2004. An autologous iliac fragment d shape and length designed according to the defect size was obtained and ground into particles and then implanted into the maxillofacial defect. The defect areas were covered with collagen membrane; fixed and sutured with fine thread and then wrapped with application of pressure. Afterward the healing and bone growth were clinically assessed with the assistance of X-ray examination. Results In the first stage of this trial all the wounds were healed sufficiendy with no evidemeof hone necrosis, and dejects healed perfectly. Conclusion Treatment using guided tissue regeneration for most kinds of bone defects in the reconstruction of oral and maxillohcial defects has proved to have promising clinical effects.