自体皮质骨联合含重组人骨形态发生蛋白2磷酸钙骨粉修复牙槽突裂的探索性研究

Clinical Observation of Alveolar Bone Graft with Autogenous Cortical Bone Combined with Calcium Phosphate Cement Powder Containing Recombinant Human Bone Morphogenetic Protein-2

目的:总结采用下颌单层皮质骨联合负载重组人骨形态发生蛋白2的自固化磷酸钙骨粉移植修复牙槽突裂的成骨效果。方法:回顾2020年12月至2021年11月间上海第九人民医院口腔颅颌面科采用上述方法治疗的牙槽突裂病例,分析成骨效果及并发症发生情况。结果:共纳入病例8例,平均骨吸收率28.88%,1例发生伤口裂开,经过治疗仍疗效良好;1例术后2周伤口裂开伴感染,术后6月拍摄电子计算机断层扫描发现移植骨与周围骨不连续,术后8月时皮质骨从裂开处排出,其余6例随访期间无明显并发症。结论:下颌单层皮质骨联合负载重组人骨形态发生蛋白2的自固化磷酸钙骨粉移植修复牙槽突裂效果良好,骨吸收率低,新生骨密度高,创伤小,具有临床推广价值。

Objective:To summarize the osteogenic effect of monocortical mandibular bone combined with calcium phosphate cement(CPC)powder containing recombinant human bone morphogenetic protein-2(rhBMP-2)in alveolar bone graft.Methods:Patients with alveolar cleft treated by the above methods from December 2020 to November 2021 were reviewed,and the bone resorption and complications were analyzed.Results:A total of 8 cases were included,the average bone resorption rate was 28.88%.One case had wound dehiscence,and the curative effect was still good after treatment.One case suffered from wound dehiscence and infection 2 weeks after operation.The CT scan at 6 months after operation indicated that the graft bone was not continuous with the surrounding bone.At 8 months after operation,the bone block was discharged from the dehiscence.Conclusions:The effect of monocortical mandibular bone combined with CPC powder containing rhBMP-2 in repairing alveolar cleft was acceptable with lower bone absorption rate,higher new bone density,less trauma,and thus valuable clinical application.