牙槽骨移植：利用合成HA/TCP和rhBMP-2与自体移植物类型的结果。

IF 3.2 2区医学 Q1 SURGERY

Plastic and reconstructive surgery Pub Date : 2025-06-17 DOI:10.1097/PRS.0000000000012257

Riley H Kahan, Skyler K Palmer, Kassra Garoosi, Diego A Gomez, David Y Khechoyan, Brooke French, Kristen Lowe, Phuong D Nguyen

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引用次数: 0

摘要

简介：唇裂和腭裂相关的牙槽嵴缺损通常采用牙槽骨移植（ABG）修复，尽管供体部位发病率高，自体移植仍是标准。本研究考察了羟基磷灰石/ β -磷酸三钙（HA/TCP）作为人工合成移植物的效果。方法：回顾性队列研究118例通过CPT编码行ABG的患者，分为三组：自体髂骨骨移植（ICBG）（N=37）、ICBG + rhBMP-2 （N=65）和15%羟基磷灰石/85% β -磷酸三钙(HA/TCP) + rhBMP-2 （N=16）。主要结果包括通过CBCT成像评估的再植骨需求和植骨率。次要结局包括并发症发生率（肿胀、伤口裂开、SSI）和围手术期数据（手术时间、住院时间）。结果：接受HA/TCP + rhBMP-2的患者与其他组的再移植率相似。HA/TCP + rhBMP-2的中位移植率（68.0% IQR[45.9-93.1%]）高于ICBG （25.1% IQR[5.2-43.5%], Z = 3.16, p = 0.002）和ICBG + rhBMP-2 （44.2% IQR[24.5-63.1%], Z = 2.19, p = 0.028）。两组间并发症发生率相似(裂隙，p = 0.319；除HA/TCP + rhBMP-2组术后面部肿胀率高于ICBG组（OR = 6.8, 95% CI[1.44-32.00], p = 0.0157）外，SSI, p = 0.357)。结论：HA/TCP + rhBMP-2是ABG的可行替代方案，与ICBG和ICBG + rhBMP-2相比取得了相当的成功，除了与ICBG相比术后面部肿胀增加外，移植成功率更高，并发症风险没有增加。

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Alveolar Bone Grafting: Outcomes Utilizing Synthetic HA/TCP and rhBMP-2 vs. Autologous Graft Types.

Intro: Alveolar ridge defects associated with cleft lip and palate are typically repaired using alveolar bone grafting (ABG), with autologous grafting as the standard despite donor site morbidity. This study investigated outcomes of using hydroxyapatite/beta-tricalcium phosphate (HA/TCP) as a synthetic graft alternative.

Methods: A retrospective cohort study identified 118 patients who underwent ABG via CPT codes and were divided into three groups: autologous Iliac Crest Bone Graft (ICBG) (N=37), ICBG + rhBMP-2 (N=65), and 15% hydroxyapatite/85% beta-Tricalcium Phosphate (HA/TCP) + rhBMP-2 (N=16). Primary outcomes included need for regrafting and % graft take, assessed via CBCT imaging. Secondary outcomes included complication rates (swelling, wound dehiscence, SSI) and perioperative data (surgery length, hospital stay).

Results: Patients who received HA/TCP + rhBMP-2 experienced similar rates of need for regrafting as the other groups. The median % graft take was higher for HA/TCP + rhBMP-2 (68.0% IQR[45.9-93.1%]) compared to ICBG (25.1% IQR[5.2-43.5%], Z = 3.16, p = 0.002) and ICBG + rhBMP-2 (44.2% IQR[24.5-63.1%], Z = 2.19, p = 0.028). Complication rates were similar across groups (dehiscence, p = 0.319; SSI, p = 0.357), except for a higher rate of post-surgical facial swelling for HA/TCP + rhBMP-2 compared to ICBG (OR = 6.8, 95% CI[1.44-32.00], p = 0.0157).

Conclusion: HA/TCP + rhBMP-2 is a viable alternative to ABG, showing comparable success to ICBG and ICBG + rhBMP-2, with superior % graft take and no increased complication risk, aside from increased post-surgical facial swelling compared to ICBG.

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来源期刊

Plastic and reconstructive surgery 医学-外科

CiteScore

5.00

自引率

13.90%

发文量

1436

审稿时长

1.5 months

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