目的:比较自体块状骨结合引导骨再生(GBR)技术重建前牙区骨量不足术后种植位点和非种植位点骨量变化的差异。方法:2010年12月—2011年8月间,术前全景片及CT评估14例患者(73个缺牙位点)前牙区骨量不足,于颏部或下颌支处取自体块状骨结合...目的:比较自体块状骨结合引导骨再生(GBR)技术重建前牙区骨量不足术后种植位点和非种植位点骨量变化的差异。方法:2010年12月—2011年8月间,术前全景片及CT评估14例患者(73个缺牙位点)前牙区骨量不足,于颏部或下颌支处取自体块状骨结合GBR技术重建前牙牙槽骨,并延期行种植体植入术(共植入42颗种植体)。术后即刻、3、6、9个月和最长随访时间点(平均13.8个月)行CT检查。利用Simplant 11.04软件三维重建并测量牙槽嵴顶骨宽度(alveolar crestal bone width,ACBW)、牙槽骨中部骨宽度(alveolar midway bone width,AMBW)和牙槽骨高度(alveolar bone height,ABH)。测量的所有数据按照种植位点(即种植体植入的位点)和非种植位点(即未植入种植体,后期利用桥体修复的位点)分为2组。采用SAS 9.0软件包对该2组数据进行配对t检验。结果:14例患者均顺利完成植骨和种植体植入手术,术后无头晕、头痛等不适,切口均愈合良好,42颗种植体在愈合和随访期内骨结合良好。术后2组骨改建评价显示:对种植位点的ACBW和AMBW,术后即刻骨增量和术后3个月骨吸收量有显著差异(P<0.05),而对ABH术后即刻骨增量,术后3、6个月骨吸收量有显著差异(P<0.05),其他时间段则无显著差异(P>0.05);对非种植位点的ACBW和ABH,术后即刻骨增量,术后3、6和9个月骨吸收量有显著差异(P<0.05),而对AMBW术后即刻骨增量,术后3、6个月骨吸收量有显著差异(P<0.05),其他时间段则无显著差异(P>0.05)。术后2组中ACBW、AMBW和ABH的骨量变化显示:术后即刻骨增量,术后3、6个月骨吸收量无显著差异(P>0.05);术后9个月和最长随访时间点骨吸收量存在显著差异(P<0.05)。结论:非种植位点较种植位点在种植体植入后发生更多的骨吸收,其原因是二期种植体植入手术产生的创伤和种植体能保存骨量两者相互作用所致。因此,即刻或同期植入种植体,避免二次手术,对骨�展开更多
BACKGROUND A patient with type Ⅲ Kummell’s disease had a ruptured posterior cortex of the fractured vertebral body, which caused spinal cord compression. An open surgery was considered the best choice of operation. ...BACKGROUND A patient with type Ⅲ Kummell’s disease had a ruptured posterior cortex of the fractured vertebral body, which caused spinal cord compression. An open surgery was considered the best choice of operation. However, the patient and her family refused open surgery and instead demanded a minimally invasive surgical treatment such as percutaneous vertebroplasty(PVP). After preoperative discussion, we finally adopted the novel therapy of traditional Chinese medicine manipulative reduction(TCMMR) combined with PVP.CASE SUMMARY A patient with type Ⅲ Kummell’s disease exhibiting bone block-induced spinal cord compression was admitted to our hospital. She suffered from a variety of medical disorders but refused open surgery, and instead asked for PVP surgery. TCMMR, in parallel with PVP, was used to restore the height of the compressed vertebral body and reduce the symptoms of spinal cord compression by the bone block in order to strengthen the vertebral body and prevent further collapse. The surgery was very successful. The height of the compressed vertebra was restored, and the symptom of spinal cord compression by bone block was reduced successfully via TCMMR. The fractured vertebra was solidified by the PVP. The pain visual analog score declined from preoperative 7 scores to postoperative 2 scores, and the Frankel spinal cord scale increased from preoperative D degree to postoperative E degree.CONCLUSION The new method has advantages in treating patients with type Ⅲ Kummell’s disease who cannot be treated with open surgery.展开更多
文摘目的:比较自体块状骨结合引导骨再生(GBR)技术重建前牙区骨量不足术后种植位点和非种植位点骨量变化的差异。方法:2010年12月—2011年8月间,术前全景片及CT评估14例患者(73个缺牙位点)前牙区骨量不足,于颏部或下颌支处取自体块状骨结合GBR技术重建前牙牙槽骨,并延期行种植体植入术(共植入42颗种植体)。术后即刻、3、6、9个月和最长随访时间点(平均13.8个月)行CT检查。利用Simplant 11.04软件三维重建并测量牙槽嵴顶骨宽度(alveolar crestal bone width,ACBW)、牙槽骨中部骨宽度(alveolar midway bone width,AMBW)和牙槽骨高度(alveolar bone height,ABH)。测量的所有数据按照种植位点(即种植体植入的位点)和非种植位点(即未植入种植体,后期利用桥体修复的位点)分为2组。采用SAS 9.0软件包对该2组数据进行配对t检验。结果:14例患者均顺利完成植骨和种植体植入手术,术后无头晕、头痛等不适,切口均愈合良好,42颗种植体在愈合和随访期内骨结合良好。术后2组骨改建评价显示:对种植位点的ACBW和AMBW,术后即刻骨增量和术后3个月骨吸收量有显著差异(P<0.05),而对ABH术后即刻骨增量,术后3、6个月骨吸收量有显著差异(P<0.05),其他时间段则无显著差异(P>0.05);对非种植位点的ACBW和ABH,术后即刻骨增量,术后3、6和9个月骨吸收量有显著差异(P<0.05),而对AMBW术后即刻骨增量,术后3、6个月骨吸收量有显著差异(P<0.05),其他时间段则无显著差异(P>0.05)。术后2组中ACBW、AMBW和ABH的骨量变化显示:术后即刻骨增量,术后3、6个月骨吸收量无显著差异(P>0.05);术后9个月和最长随访时间点骨吸收量存在显著差异(P<0.05)。结论:非种植位点较种植位点在种植体植入后发生更多的骨吸收,其原因是二期种植体植入手术产生的创伤和种植体能保存骨量两者相互作用所致。因此,即刻或同期植入种植体,避免二次手术,对骨�
文摘BACKGROUND A patient with type Ⅲ Kummell’s disease had a ruptured posterior cortex of the fractured vertebral body, which caused spinal cord compression. An open surgery was considered the best choice of operation. However, the patient and her family refused open surgery and instead demanded a minimally invasive surgical treatment such as percutaneous vertebroplasty(PVP). After preoperative discussion, we finally adopted the novel therapy of traditional Chinese medicine manipulative reduction(TCMMR) combined with PVP.CASE SUMMARY A patient with type Ⅲ Kummell’s disease exhibiting bone block-induced spinal cord compression was admitted to our hospital. She suffered from a variety of medical disorders but refused open surgery, and instead asked for PVP surgery. TCMMR, in parallel with PVP, was used to restore the height of the compressed vertebral body and reduce the symptoms of spinal cord compression by the bone block in order to strengthen the vertebral body and prevent further collapse. The surgery was very successful. The height of the compressed vertebra was restored, and the symptom of spinal cord compression by bone block was reduced successfully via TCMMR. The fractured vertebra was solidified by the PVP. The pain visual analog score declined from preoperative 7 scores to postoperative 2 scores, and the Frankel spinal cord scale increased from preoperative D degree to postoperative E degree.CONCLUSION The new method has advantages in treating patients with type Ⅲ Kummell’s disease who cannot be treated with open surgery.
