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牙槽嵴裂是由于胚胎发育期球状突和上颌突融合障碍所致。其常表现为牙弓的连续性消失、颌骨骨质缺损、口鼻瘘、牙齿的缺失或异位萌出、鼻翼塌陷等[1]。牙槽嵴裂的存在也严重影响到了唇腭裂术后恢复的效果,造成牙齿的萌出及修复障碍,阻碍了后期正畸及正颌的治疗[2]。牙槽嵴裂手术是通过植骨恢复牙槽突的骨质的连续性和关闭软组织间隙。本文对改良式牙槽嵴裂植骨术及常规牙槽嵴裂植骨术病人术后植骨成功率及影像学资料进行分析,对2种术式术后恢复情况进行评价。现作报道。
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A组术后成功率为82.8%(18例),B组术后成功率为50.0%(11例),A组高于B组(χ2=4.96,P < 0.05)。
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术后第3、6、12个月时缺损区域植骨存活比A组均高于B组(P < 0.05)。2组病人第3个月时植骨存活比均高于第6个月和第12个月(P < 0.01);第6个月和第12个月植骨存活比差异无统计学意义(P>0.05)(见表 1)。
分组 n 3个月 6个月 12个月 F P A组 22 69.67±7.63 52.45±9.17** 49.43±8.28** 46.37 < 0.01 B组 22 64.32±8.96 46.73±9.07** 43.81±8.58** 40.35 < 0.01 t — 2.13 2.08 2.21 — — P — < 0.05 < 0.05 < 0.05 — — q检验:与3个月时比较**P < 0.01 表 1 2组病人不同时点植骨存活比比较(x±s;%)
改良式牙槽嵴裂植骨术后的植骨效果评价
Evaluation of bone graft effect after modified alveolar bone grafting
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摘要:
目的对改良式牙槽嵴裂植骨术修复牙槽嵴裂的术后效果进行评价。 方法采用随机对照试验分析44例单侧牙槽嵴裂病人的临床资料,其中改良式牙槽嵴裂植骨术组(A组)22例和常规牙槽嵴裂植骨术组(B组)22例。术后第3、6、12个月进行随访,比较2组病人的术后植骨成功率及骨缺损处的体积变化。 结果A组术后成功率为82.8%(18例)高于B组的50.0%(11例)(P < 0.05);术后第3、6、12个月时缺损区域植骨存活比A组均高于B组(P < 0.05)。2组病人术后第3个月时植骨存活比均高于第6个月和第12个月(P < 0.01),第6个月和第12个月植骨存活比差异均无统计学意义(P>0.05)。 结论对于单侧牙槽嵴裂病人,改良式牙槽嵴裂植骨术可有效提高术后植骨存活率,术后骨量恢复明显增加;术后骨吸收主要发生于术后前6个月,6~12个月时基本稳定。 Abstract:ObjectiveTo estimate the bone graft effect after modified alveolar bone grafting(ABG). MethodsThe clinical data of 44 patients with unilateral alveolar cleft were retrospectively analyzed.The patients were divided into the modified ABG approach group(group A, 22 cases) and conventional ABG group(group B, 22 cases), and followed up for 12 months.The successful rate of bone graft and recovery of bone volumen between two groups after operation were compared. ResultsThe successful rate of operation in group A (82.8%) was higher than that in group B(50.0%) (P < 0.05).After 3, 6 and 12 month, the survival of graft in defect region in group A was higher than that in group B(P < 0.05).The survival of graft in defect region in two groups after 3 months were higher than that after 6 and 12 months(P < 0.01), and the difference of survival of graft in defect region bewteen 6 and 12 months in two groups were not statistically significant(P>0.05). ConclusionsFor patients with unilateral alveolar cleft, the modified alveolar bone grafting can effectively improve the survival rate of bone graft, and the recovery of bone mass obviously increases after operation.The postoperative bone resorption mainly occurs in the first 6 months of operation, and is basically stable at 6 to 12 months. -
表 1 2组病人不同时点植骨存活比比较(x±s;%)
分组 n 3个月 6个月 12个月 F P A组 22 69.67±7.63 52.45±9.17** 49.43±8.28** 46.37 < 0.01 B组 22 64.32±8.96 46.73±9.07** 43.81±8.58** 40.35 < 0.01 t — 2.13 2.08 2.21 — — P — < 0.05 < 0.05 < 0.05 — — q检验:与3个月时比较**P < 0.01 -
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