黏骨膜-骨瓣术和传统刮治术治疗颌骨囊肿对比研究

Comparative study between bone flap with mucoperiosteum and traditional curettage for the treatment of jaw cyst

目的:探索黏骨膜-骨瓣术式对颌骨囊肿治疗的临床效果。方法:纳入50例颌骨囊肿患者分成2组,观察组25例采用黏骨膜-骨瓣术式,对照组25例采用传统刮治术式。比较两组患者的手术时间、术后反应、CBCT评价骨腔成骨修复效果。结果:手术时间和术后肿胀两组无统计学差异(P≥0.410),但观察组疼痛评分(VAS)显著低于对照组(P<0.001),观察组骨腔体积、表面积及灰度值变化百分率显著大于对照组(P≤0.005)。术后6个月随访,观察组骨框架基本完整,仅遗留较小骨腔,开窗处未见塌陷;而对照组骨窗的框架丧失,仍遗留较大骨腔,开窗处可见明显塌陷畸形。结论:颌骨囊肿黏骨膜-骨瓣术式保存了骨及骨框架,加快了成骨比率,显著缩小了骨腔,具有更好的成骨修复效果。

Objective:To study the clinical effects of bone flap with the mucoperiosteum in the treatment of jaw cyst.Methods:50 patients with jaw cyst were enrolled and divided into observation group and control group(n=25),the patients in the observation group were treated with the operation of bone flap with the mucoperiosteum,those in the control group were treated with traditional curettage operation.The operation time and postoperative reaction of the 2 groups were compared.CBCT was used to analyse the osteogenic repair effect of bone cavity.Results:There was no significant difference in operation time and postoperative swelling between the 2 groups(P=0.410),but the pain score(VAS)in the observation group was lower than that in the control group(P<0.001),the percentage of change in volume,surface area and gray value of bone cavity in the observation group was significantly higher than that in the control group(P<0.05).At 6 months follow-up,the bone frame of the observation group was basically intact,only a small bone cavity was left,and no collapse was observed at the fenestration site.In the control group,the frame of the bone window was lost,large bone cavity existed,and obvious collapse was observed at the fenestration site.Conclusion:The operation of bone flap with the mucoperiosteum preserves the bone and bone frame,accelerates the osteogenesis,reduces the bone cavity,and has better osteogenic repair effect.