DDM联合口腔生物膜在颌骨囊肿刮治术后骨缺损中的临床效果  

Clinical efficacy of DDM combined with oral biofilm in bone defects after cu⁃rettage of jaw cyst

作　　者：张恺 王玲 胡程程 周飞扬 孙晋虎 郑纪伟 ZHANG Kai;WANG Ling;HU Cheng⁃cheng;ZHOU Fei⁃yang;SUN Jin⁃hu;ZHENG Ji⁃wei(Department of Stomatology,Xuzhou Medical University School of Stomatology/Xuzhou Medical University Affiliated Hospital,Xuzhou 221000,China)

机构地区：[1]徐州医科大学口腔医学院/徐州医科大学附属医院口腔科,江苏徐州221000

出　　处：《哈尔滨医科大学学报》2024年第5期506-510,共5页Journal of Harbin Medical University

基　　金：徐州医科大学院级科研项目(2021ZA45);全国大学生创新创业训练项目(202210313116Y)

摘　　要：目的 探究脱矿牙本质基质(demineralized dentin matrix, DDM)联合口腔生物膜修复颌骨囊肿刮治术后骨缺损的效果。方法 选取2020年1月~2023年1月在徐州医科大学附属医院接受手术治疗的98例颌骨囊肿患者的病历进行回顾性分析。根据治疗方法分为两组,对照组44例,观察组54例。所有患者行颌骨囊肿刮治术,于术中囊肿摘除后,对照组填充Bio-Oss骨粉,并覆盖口腔生物膜。观察组填充DDM,并覆盖口腔生物膜。记录术中出血量、手术时间和住院时间。术前、术后6个月、术后12个月,比较两组的骨密度HU值。术后6个月,比较两组的骨质增生厚度、囊肿体积缩小率。术后1个月,检测血清基质金属蛋白酶(matrix metalloproteinase-9,MMP-9)、血清半胱氨酸组织蛋白酶(cysteinyl cathepsins, CC)、血清神经肽Y(neuropeptide Y,NPY)、血清P物质(substance P,SP),记录疼痛程度评分及术后并发症。结果 两组术中出血量、手术时间、住院时间及术后并发症发生率比较,差异无统计学意义(P>0.05)。术前、术后6个月、术后12个月,两组患者的HU均逐渐升高(P<0.05)。术后6个月、术后12个月,观察组患者的HU值高于对照组(P<0.05)。术后6个月,观察组患者的骨质增生厚度及囊肿体积缩小率均高于对照组(P<0.05)。术后1个月,两组患者的血清MMP-9、CC均降低,观察组低于对照组(P<0.05)。两组治疗后的疼痛评分、血清NPY、血清SP比较无差异(P>0.05)。结论 DDM联合口腔生物膜修复颌骨囊肿刮治术后骨缺损,有助于促进骨缺损的修复,安全性良好。Objective To explore the effect of demineralized dentin matrix(DDM)combined with oral biofilm in repairing bone defects after curettage of jaw cyst.Methods A retrospec⁃tive analysis was conducted on the medical records of 98 patients with jaw cysts who underwent surgical treatment at the Xuzhou Medical University School of Stomatology/Xuzhou Medical U⁃niversity Affiliated Hospital from January 2020 to January 2023.The patients were divided into two groups according to the treatment method:a control group(n=44)and an observation group(n=54).All patients underwent cystectomy,and after cyst removal,the control group was filled with Bio⁃Oss bone powder followed by coverage with oral biofilm,while the study group was filled with DDM followed by coverage with oral biofilm.Intraoperative blood loss,operation time,and hospital stay were recorded.The HU values of bone density were compared between the two groups before surgery,6 months and 12 months after surgery.The bone miner⁃alization thickness and cyst volume reduction rate were compared between the two groups 6 months after surgery.One month after surgery,the levels of serum matrix metalloproteinase⁃9(MMP⁃9),serum cysteine protease(CC),serum neuropeptide Y(NPY),and serum sub⁃stance P(SP)were detected,and pain score and postoperative complications were recorded.Results The differences in intraoperative blood loss,surgical time,length of hospital stay,and postoperative complication rate between the two groups were not statistically significant(P>0.05).The HU values gradually increased at preoperative,6 months postoperative,and 12 months postoperative time points(P<0.05).The HU values of the study group were higher than those of the control group at 6 months postoperative and 12 months postoperative(P<0.05).At 6 months postoperative,the study group had higher bone formation thickness and cyst volume reduction rate compared with the control group(P<0.05).At 1 month postopera⁃tive,both groups showed a decrease in serum MMP⁃9 and CC levels,with the study

关 键 词：颌骨囊肿 颌骨囊肿刮治术 脱矿牙本质基质 口腔生物膜 骨修复 

分 类 号：R783.6[医药卫生—口腔医学]