牙槽骨增量骨皮质切开术后2种植骨材料成骨的影像学分析

Radiographic analysis of osteogenesis of two bone implant materials after augmented corticotomy-assisted surgical orthodontics

目的:探讨错畸形患者牙槽骨增量骨皮质切开术的成骨效果。方法:收集进行牙槽骨增量骨皮质切开术的错畸形患者42例,分为2组,瑞邦骨粉植骨22例(第1组),Bio-oss骨粉植骨20例(第2组)。应用锥形束CT(conebeam CT,CBCT)测量2组患者术前(T0)、术后2周(T1)、术后3个月(T2)、术后6个月(T3)牙槽骨相关指标,采用SPSS 21.0软件包对数据进行单因素方差分析。结果:第2组的唇侧骨高度(HL)在T0至T2时增加(P<0.001);2组的根尖部唇侧骨厚度(TL1)及根中部唇侧骨厚度(TL2)在T0至T1时增加,T1至T2时减少(P<0.001);2组的根尖非植骨区域CT值(CTn)在T0至T1时减少,T1至T3时增加(P<0.001);2组的植骨区域CT值(CTg)在T1至T3时减少(P<0.001)。TL1、TL2、CTn、CTg的组间差异有统计学意义(P<0.001)。结论:错畸形患者通过牙槽骨增量骨皮质切开术,可在术区实现充分的骨增量,无明显牙周损伤及牙根吸收。2种植骨材料成骨效果理想,术后随访半年,成骨情况稳定。

PURPOSE:To evaluate the osteogenesis for patients with malocclusion after augmented corticotomy-assisted surgical orthodontics.METHODS:Forty-two patients with malocclusion augmented corticotomy-assisted surgical orthodontics were selected in this study.The patients were divided into 2 groups,twenty-two were treated with Rebone(group 1),twenty were treated with Bio-oss(group 2).Cone-beam CT was used to measure the alveolar bone indexes of the two groups at different time(T0:preoperative,T1:after 2 week,T2:after 3 month,T3:after 6 month).SPSS 21.0 software package was used for statistical analysis.RESULTS:Among the 42 patients,the labial bone height(HL)in group 2 increased from T0 to T2(P<0.001);the apical labial bone thickness(TL1)and middle root labial bone thickness(TL2)increased from T0 to T1 and decreased from T1 to T2(P<0.001).CT value of the area without bone graft(CTn)decreased from T0 to T1 and increased from T1 to T3(P<0.001).CT value of the bone graft area(CTg)decreased from T1 to T3(P<0.001).The differences of TL1,TL2,CTn,and CTg between the two groups were significant(P<0.001).CONCLUSIONS:Patients with malocclusion can achieve sufficient bone increment in the operation area through augmented corticotomy-as-sisted surgical orthodontics,without periodontal injury and root resorption.The osteogenic effect of the two materials was ideal,and the osteogenesis was stable after half a year follow-up.