脱钙人牙基质在修复齿槽突裂中的应用研究  

CLINICAL APPLICATION OF DECALCIFIED DENTINAL MATRIX OF HUMAN TO REPAIR ALVEOLAR CLEFT

作　　者：张雷 霍永力 王建华 李华 邢建峰 孙志干 冯驰 刘英华 

机构地区：[1]银川市口腔医院颌面外科,银川750004

出　　处：《中国修复重建外科杂志》2008年第3期336-338,共3页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：宁夏银川市科学技术研究基金资助项目(06-1-67)~~

摘　　要：目的研究唇腭裂术后齿槽突裂植骨修复的新方法。方法2005年4月-2006年8月,采用自体髂骨松质骨混合脱钙人牙基质(decalcifieddentinalmatrixofhuman,DDM)治疗26例(30侧)齿槽突裂患儿。男16例,女10例;年龄6～12岁。单侧齿槽突裂22例,双侧4例。伴鼻翼塌陷26例,乳牙滞留5例,错位牙3例,畸形牙1例。患儿于术前、术后1周,1、2、3、6和12个月摄全口曲面断层X线片、上颌前部咬牙合X线片(以裂隙侧尖牙为中心),观察骨愈合、骨吸收情况。结果术后23例患儿伤口Ⅰ期愈合,口鼻瘘严密关闭;1例双侧齿槽突裂切口感染,6个月后重新植骨;2例少量骨组织外露,予冲洗、换药、涂擦美宝湿润烧伤膏后伤口愈合。髂骨供区均Ⅰ期愈合。术后X线片可见裂隙间骨桥形成,恢复了颌骨的连续性和稳定性。4例6～9岁患儿平均观察6.5个月,22例9～12岁患儿平均观察8.6个月。根据术后3个月X线片,采用Bergland等评价标准进行疗效分级,Ⅰ级16例16侧(53.3%),Ⅱ级7例8侧(26.7%),Ⅲ级2例4侧(13.3%),Ⅳ级1例2侧(6.7%)。植入骨成活率为93.3%,临床成功率为80%。结论采用DDM联合髂骨松质骨修复齿槽突裂,能减少骨吸收,是一种新骨形成的加速剂,骨生成潜能好、骨诱导明显,临床成功率高。Objective To study a new method of alveolar cleft bone graft repair. Methods From April 2005 to August 2006, 26 cases （30 sides） of alveolar cleft were treated with trabecular substance of self-ilium combined with the decalcified dentinal matrix of human （DDM）. There were 16 males and 10 females, aged 6-12 years. Unilateral alveolar cleft was involved in 22 cases, bilateral alveolar cleft in 4 cases. All cases were accompanied by nasal wing collapse, 5 by deciduous tooth retention, 3 by malposed teeth and 1 by tooth deformity. Anterior ocdusal radiographs and panoramic oral radiographs were taken to observe union and bone absorption before and after operation. Results Twenty-three patients achieved healing by first intention, oronasal fistulas were dosed successfully. Infection occurred in one bilateral alveolar cleft case and bone tissue exposure in 2 cases. Wound healed by rinse or dressing change and inunction with MEBO. The X-ray films after operation showed bone bridge formation in the alveolar cleft. The stability and continuity of body of maxiUa were resumed. Four cases （6-9 years old） were observed 6.5 months, 22 cases （9-12 years old ） were observed 8.6 months. According to Bergland for evaluation, the X-ray films after 3 months of operation showed 16 cases （16 sides） in dass Ⅰ （53.3%）, 7 cases （8 sides） in class Ⅱ （26.7%）, 2 cases （4 sides） in classⅢ（13.3%）, and 1 case（2 sides） in dass Ⅳ （6.7%）. The overall survival ratio of alveolar bone grafting was 93.3%, and the clinical success ratio was 80%. Conclusion The DDM is good in alveolar deft bone graft repair. It is better than using self-ilium only dinicaUy.

关 键 词：齿槽突裂 植骨 脱钙人牙基质 

分 类 号：R783[医药卫生—口腔医学]