牙源性颌骨囊肿刮治术后应用口腔修复膜和富自体浓缩生长因子的价值

Value of Oral Repair Membrane and Autologous Concentration of Growth Factor After Curettage of Odontogenic Jaw Cyst

目的分析牙源性颌骨囊肿刮治术后应用口腔修复膜和富自体浓缩生长因子的价值。方法选取2017年1月至2021年12月郑州颐和医院口腔科择期进行牙源性颌骨囊肿刮治术的108例牙源性颌骨囊肿患者,随机分为3组,各36例。A组术后不做任何处理,B组术后使用富自体浓缩生长因子+骨粉填充骨缺损区表面,C组术后使用富自体浓缩生长因子+骨粉填充骨缺损区表面后应用口腔修复膜覆盖创面进行治疗。分别于术后3、6、12个月时进行锥形束计算机体层扫描复查,测量患者骨缺损区HU值,以及曲面体层片和CBCT冠状面、矢状面、横断面HU值,并统计丧失功能牙数及术后恢复正常牙数,评估骨质恢复效果。结果术后6个月时,3组患者曲面体层片、冠状面、矢状面、横断面HU值和较术后3个月升高(P<0.05);术后12个月时,3组患者曲面体层片、冠状面、矢状面、横断面HU值较术后6个月升高(P<0.05);术后3、6、12个月时,C组曲面体层片、冠状面、矢状面、横断面HU值均高于B组和A组,且组间两两比较,差异有统计学意义(P<0.05)。术前,3组患者骨缺损区CT值和丧失功能牙数组间差异无统计学意义(P>0.05);术后6个月时,3组患者骨缺损区CT值和恢复正常牙数较术后3个月升高(P<0.05);术后12个月时,3组患者骨缺损区CT值和恢复正常牙数较术后6个月升高(P<0.05);术后3、6、12个月时,C组患者骨缺损区CT值和恢复正常牙数均高于B组和A组,且组间两两比较,差异有统计学意义(P<0.05)。结论牙源性颌骨囊肿刮治术后使用富自体浓缩生长因子+骨粉填充后应用应用口腔修复膜覆盖可提高骨质恢复效果,促进牙恢复,可为临床颌骨缺损修复提供指导。

Objective To analyze the value of oral repair membrane and autologous concentration of growth factor after curettage of odontogenic jaw cyst.Methods From January 2017 to December 2021,108 patients with odontogenic jaw cyst underwent curettage in Stomatology Department of Zhengzhou Yihe Hospital and were randomly divided into 3 groups with 36 cases each.Group A was treated without any treatment after surgery,group B was treated with autologous concentrated growth factor+bone meal to fill the surface of the bone defect area,group C was treated with autologous concentrated growth factor+bone meal to fill the surface of the bone defect area with oral repair membrane to cover the wound area.The conical beam computerized tomography was performed at 3,6 and 12 months after surgery to measure the HU values in the bone defect area,as well as the coronal,sagittal and cross-sectional HU values of the curved body slice and CBCT,and the number of teeth that lost function and recovered after surgery to evaluate the effect of bone recovery.Results At 6 months after operation,the HU values of curved body slice,coronal plane,sagittal plane and cross section in 3 groups were higher than those at 3 months after operation(P<0.05).At 12 months after surgery,HU values of curved body slice,coronal plane,sagittal plane and cross section in 3 groups were higher than those at 6 months after surgery(P<0.05).At 3,6 and 12 months after operation,the HU values of surface body slice,coronal plane,sagittal plane and cross section in group C were higher than those in group B and group A,and pairwise comparison between groups showed statistically significant differences(P<0.05).Before surgery,there was no significant difference in CT value of bone defect area and array of teeth with loss of function among 3 groups(P>0.05).At 6 months after surgery,the CT value of bone defect area and the number of teeth restored to normal in 3 groups were higher than that at 3 months after surgery(P<0.05).At 12 months after surgery,the CT value of bone defect area and the number of teeth restored to normal in 3 groups were higher than that at 6 months after surgery(P<0.05).At 3,6 and 12 months after surgery,CT value of bone defect area and number of restored normal teeth in group C were higher than those in group B and group A,and the difference was statistically significant(P<0.05).Conclusion After curettage of odontogenic jaw cyst,the use of autologous concentrated growth factor+bone powder filling can improve the effect of bone recovery,promote tooth recovery,and provide guidance for clinical jaw defect repair.