医用硫酸钙OsteoSet修复颌骨缺损的疗效评价

目的评价医用硫酸钙OsteoSet骨移植替代物在颌骨囊性病变切除后骨缺损治疗中的效果。方法 2009年12月-2010年5月,收治15例颌骨囊性病变患者。其中男9例,女6例;年龄15～75岁,平均36.6岁。患者术前均摄颌骨全景断层片(orthopantomography,OPT)测量囊肿大小,范围为1.5 cm×1.5 cm～8.0 cm×3.0 cm。均采用囊肿刮治术加OsteoSet骨移植替代物移植术进行治疗,术中囊肿切除后骨缺损范围为1.5 cm×1.5 cm×1.5 cm～8.0 cm×3.0 cm×3.0 cm,OsteoSet骨移植替代物植入量为2～15 mL。通过影像学方法评估OsteoSet骨移植替代物的成骨效果。结果术后病理检查提示:根尖周囊肿7例、牙源性角化囊肿5例、含牙囊肿3例。15例均获随访,随访时间6～12个月。13例患者切口Ⅰ期愈合;2例术后引流时间延长,分别为5 d和7 d,经加压包扎处理后切口愈合良好。1例术后1个月复查出现肿胀,无感染症状;无1例出现术后感染和排斥反应。所有患者术后1 d均行X线检查,见材料将骨缺损充填良好;术后1个月颌骨OPT复查发现植入的OsteoSet颗粒吸收近半;术后3个月植入的OsteoSet颗粒全部吸收,原囊腔低密度影面积明显变小,囊腔内高密度影增加明显,囊腔边界模糊;术后6个月原囊腔内影像密度与正常骨组织密度差别不明显,囊腔边界消失,新骨基本充满缺损区。结论医用硫酸钙OsteoSet骨移植替代物是一种理想的骨缺损充填材料。

Effect evaluation of medical calcium sulfate--OsteoSet in repairing jaw bone defect

Objective To investigate the effectiveness of the medical calcium sulfate—OsteoSet bone graft substitute in the treatment of defect after excision of jaw cyst.Methods Between December 2009 and May 2010,15 cases of jaw cystic lesion were treated,including 9 males and 6 females with an average age of 36.6 years(range,15-75 years).Orthopantomography(OPT) method was used to measure the cyst size before operation,and the size ranged from 1.5 cm × 1.5 cm to 8.0 cm × 3.0 cm.The range of bone defect was from 1.5 cm × 1.5 cm × 1.5 cm to 8.0 cm × 3.0 cm × 3.0 cm after cyst excision intraoperatively.The patients underwent cyst curettage and OsteoSet bone graft substitutes implantation(2-15 mL).Radiological method was used to evaluate the repair effect of OsteoSet pellets.Results The pathology biopsy was periapical cyst in 7 cases,odontogenic keratocyst in 5 cases,and dentigerous cyst in 3 cases.Fifteen patients were followed up 6-12 months.Thirteen patients achieved wound healing by first intention;2 cases had longer drainage time(5 and 7 days,respectively),the incision healed after the pressure bandage.Swelling occurred in 1 case after 1 month with no symptom of infection.No postoperative infection and rejection was found.The X-ray examination showed that the materials filled the bone defect well after 1 day of operation.OsteoSet bone graft substitutes were absorbed by one-half after 1 month of operation and totally after 3 months by OPT.The low density area was smaller in the original cysts cavity,and high density in the cysts increased significantly with fuzzy boundaries of cysts.At 6 months after operation,there was no obvious difference in image density between the original cavity and normal bone,and the capsule cavity boundary disappeared,and defect area was full of new bone.Conclusion The medical calcium sulfate—OsteoSet bone graft substitute is an ideal filling material for bone defect.