目的:评估浓缩生长因子(CGF)的作用,结合髂松质和复合骨材料的混合物,关于下颌骨广泛缺损的修复。
方法:该临床试验涉及由大囊性病变引起的下颌骨缺损患者。试验组16例患者接受CGF联合髂松质骨和复合骨材料修复广泛的下颌骨缺损,而对照组包括8例接受血管化游离腓骨移植治疗下颌骨节段缺损的患者。1日采集患者术后渗出液,2nd,3rd,术后第4天,和成骨因子,包括碱性磷酸酶(ALP),骨钙蛋白(BGP),和I型前胶原N端前肽(PINP),和炎性细胞因子进行。此外,在手术前后进行常规锥形束计算机断层扫描(CBCT)扫描。
结果:在术后1-4天,ALP的表达水平,BGP,PINP在试验组中较高,而IL-1α,IL-1β,IL-6、IL-8和TNF-α,被鉴定为共差异表达炎症细胞因子,在测试组的分泌中均下调。常规CBCT放射学扫描显示,实验组具有显着的成骨作用。
结论:使用CGF联合髂松质骨和复合骨材料修复下颌骨广泛缺损,有利于骨形成,并在短期内减少缺损区域的炎症。值得在临床实践中进一步研究。
OBJECTIVE: To evaluate the effects of concentrated growth factor (CGF), combined with a mixture of iliac cancellous and composite bone materials, on the repair of extensive mandibular defects.
METHODS: This clinical trial involved patients with mandibular defects caused by large cystic lesions. The test group comprised 16 patients who underwent CGF combined with iliac cancellous bone and composite bone materials to repair extensive mandibular defects, whereas the control group comprised eight patients who underwent vascularised free fibula grafts for mandibular segmental defects. Postoperative exudatum was collected from patients on the 1st, 2nd, 3rd, and 4th days postoperatively, and osteogenic factor, including alkaline phosphatase (ALP), osteocalcin (BGP), and procollagen type I N-terminal propeptide (PINP), and inflammatory cytokines were performed. Additionally, regular cone beam computed tomography (CBCT) scans were conducted before and after surgery.
RESULTS: On postoperative days 1-4, the expression levels of ALP, BGP, and PINP were higher in the test group, while those of IL-1α, IL-1β, IL-6, IL-8, and TNF-α, which were identified as co-differentially expressing inflammatory cytokines, were all down-regulated in the exudatum of the test group. Regular CBCT radiological scans revealed a significant osteogenic effect in the test group.
CONCLUSIONS: The use of CGF combined with iliac cancellous bone and composite bone materials to repair extensive mandibular jaw defects facilitates bone formation and reductions in inflammation in the defect area in the short term, which deserves further research in clinical practice.