脱钙人牙基质诱导急性创伤性颅骨缺损一次性自体修复的实验及临床应用研究

目的本研究旨在探索一种创伤性颅骨缺损自体修复的新材料及急性期术中一次性修复的新方法。方法采用弃用人牙提取脱钙人牙基质,利用其中的骨形态发生蛋白(bone morphogenetic protein,BMP),在动物实验诱导骨再生修复成功后,对22例创伤性颅骨缺损在急性期进行术中一次性修复。病人年龄8~64岁,颅骨缺损范围4~5 cm 14例,6~8 cm 8例;开放伤17例,闭合伤5例。颅骨缺损区用脱钙人牙基质2~6g,与颅骨碎粒及骨屑均匀混合平敷在硬膜外颅骨缺损区内,术后临床检查、X线评价,CT多点骨密度值测定。结果术后第3周修补区能耐受压力,X片见骨窗区骨碎粒逐渐融合,CT值由最初20~40Hu上升200~700Hu,1年后,900Hu。全部病例无感染发生,未显免疫排斥反应。结论从弃用人牙提取人的BMP,用此材料对创伤性颅骨缺损急性期术中一次性修复,简单、有效。变二次手术一次完成,有别于传统的颅骨修复方法,具良好的应用前景。

Experimental and clinical study on primary repair of traumatic skull defect with decalcified humen dental matrix in acute period

Objective To search for a new method for repair of traunmatic skull defect.Methods Decalcified humen dental martix was made from abanoloned human dentin.Bone morphogenetic protein was used on patients.After animal model was made successfully,22 patients with traunmtic defect of cranial bone were primarily repaired.The cranial defects were repaired with mixed-material of 2-6g decalcified humen dental martix and fraction of cranial bone.Results The mixed-material hardened after 3 weeks.Initial measurement of CT scaning was 20-40Hu,after that,raised 200-700Hu,and > 900Hu after l year.Conclusion The humen BMP was made from abanoloned human dentin.Primary repair of cranial defect was performed in traunmtic head injury with the kind of material in acute period.The method was different from traditional methods,and had better application.