人工骨材料β⁃磷酸三钙在牙槽嵴裂骨缺损修复中的应用  

Clinical application ofβ⁃tricalcium phosphate artificial bone material for alveolar cleft repair

作　　者：陈凯歌 陈仁吉[2] 郭思远 林雨楠 CHEN Kaige;CHEN Renji;GUO Siyuan;LIN Yunan(Department of Stomatology,the Fourth Hospital of Hebei Med-ical University,Shijiazhuang 050011,China;Department of Oral and Maxillofacial Surgery,Capital Medical University School of Stomatology,Beijing 100050,China)

机构地区：[1]河北医科大学第四医院口腔科,河北石家庄050011 [2]首都医科大学附属北京口腔医院整形创伤科,北京100050

出　　处：《口腔疾病防治》2023年第4期252-256,共5页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：北京市自然科学基金面上项目(7212046)。

摘　　要：目的探讨β⁃磷酸三钙(β⁃tricalcium phosphate,β⁃TCP)、骨形态发生蛋白⁃2(bone morphogenetic pro⁃tein⁃2,BMP⁃2)在牙槽嵴裂修复中的成骨效果。方法选择2016年1月-2021年5月于首都医科大学附属北京口腔医院就诊的单侧牙槽嵴裂患者59例,根据使用骨修复材料的不同将其分为3组,A组为自体骨,共22例;B组为β⁃TCP,共18例;C组为BMP⁃2+β⁃TCP,共19例。将同一患者术前术后CBCT数据导入Mimics 21.0软件中,通过CBCT三维重建的方法,分别计算术前骨缺损体积及新成骨体积,计算成骨率,评估其成骨效果。结果3组术后伤口均愈合良好,无植入材料排出,无感染、裂开、排异等症状。术后12个月,3组患者CBCT扫描及三维重建图像可见牙槽嵴裂隙区内有新生骨桥形成,新生骨组织在影像密度上与正常骨组织没有明显差别,上颌骨的连续性得到不同程度的恢复。自体骨组成骨率为65.00%±16.66%,β⁃TCP组及BMP⁃2+β⁃TCP组成骨率分别为69.82%±17.60%、71.35%±17.51%,与自体骨组比较,差异均无统计学意义(P=0.382、P=0.244);且β⁃TCP组与BMP⁃2+β⁃TCP组两组成骨率相比,差异无统计学意义(P=0.789)。结论β⁃TCP可以替代自体骨用于修复牙槽嵴裂,β⁃TCP中添加BMP⁃2并未明显提高成骨率。Objective To investigate the osteogenic effect ofβ⁃tricalcium phosphate(β⁃TCP)and bone morphoge⁃netic protein⁃2(BMP⁃2)in the repair of the alveolar cleft.Methods Fifty⁃nine patients with unilateral alveolar cleft who visited Capital Medical University School of Stomatology from January 2016 to May 2021 were included.They were divided into three groups according to the different bone repair materials:autologous bone,β⁃TCP and BMP⁃2+β⁃TCP.The preoperative and postoperative CBCT data of the patients were imported into Mimics 21.0 software.The preopera⁃tive volume of the bone defect and the new volume of bone formation were calculated by the three⁃dimensional recon⁃struction method.The osteogenesis rate was calculated to evaluate the osteogenesis effect.Results The wounds in the three groups healed well after the operation,without implant material discharge,infection,dehiscence,rejection or other symptoms.Twelve months after the operation,CBCT scanning and three⁃dimensional reconstruction images of the three groups of patients showed the formation of new bone bridges in the alveolar ridge fissure area.The image density of the new bone tissue was not significantly different from that of normal bone tissue,and the continuity of the maxilla was re⁃stored to varying degrees.The bone rate of autogenous bone was 65.00%±16.66%,β⁃TCP group and BMP⁃2+β⁃The bone composition rate of TCP was 69.82%±17.60%,71.35%±17.51%,respectively,and there was no significant dif⁃ference compared with the autogenous bone group(P=0.382,P=0.244).Theβ⁃TCP and BMP⁃2+β⁃TCP groups had no significant differences in bone rate(P=0.789).Conclusionβ⁃TCP could be used to replace autologous bone for alveolar cleft repair.The addition of BMP⁃2 toβ⁃TCP did not significantly improve the osteogenesis rate.

关 键 词：牙槽嵴裂 腭裂 自体骨移植 β⁃磷酸三钙 骨形态发生蛋白⁃2 骨修复材料 骨缺损修复 骨结合 

分 类 号：R78[医药卫生—口腔医学]