| ObjectiveTo investigate the effect of CGF(concentrate growth factor)combined with Osteogenic material and oral biofilm on the postoperative bone defect in patients with jaw cysts,and to observe the effect of autologous hematopoietic repair,and to provide theoretical guidance for clinical application.Method(1)Case selection and grouping:In this experiment,50patients are taken as research objectives from Stomology Hospital,Shandong University from July.2014 to Oct.2016.The diameter of cyst is 1 to 4cm.The patients are randomly divided into experimental group and control group.The experimental group was CGF+bio-oss bone meal+Haiao oral biofilm,while the control group was not implanted with any material after operation,and the bone defect were filled with autologous blood.The experimental group is of 25 patients,18 male and 7 female;aged 23-55years,mean 35.5years;maxillary bone in 15 cases,mandibular 10 cases;14 cases of apical cysts,6 cases of dentigerous cysts,nasopalatine cyst 2 cases,the globulomaxillary cyst 1 case,odontogenic keratocystic tumor in 2cases;the size of the cyst range from 2.25 to 6.85cm2(mean size 4.41 ±1.14).The control group is of 25 patients,16 male and 9 female;aged 16-60years,mean 37.4years;maxillary bone in 12 cases,mandibular 13 cases;13 casesof apical cysts,10 cases of dentigerous cysts,nasopalatine cyst 1 cases,the globulomaxillary cyst 0 case,odontogenic keratocystic tumor in 1 cases;the size of the cyst range from 1.5to 6.97cm2(mean size 4.11 ±1.35).(2)Surgical methods:All 50 patients should take OPG(Orthopantomography)and CBCT(cone-beam computer tomography)before operation.Cyst curettage was underwent after local anesthesia or general anesthesia.In the experimental group,autologous venous blood was collected and centrifuged for 13min to obtain CGF.Then the CGF was cut into 1mm granules and mixed with bio-oss bone meal.After the cysts were removed,the bone defect area was filled with CGF+bone poweder mixture.The surface was covered with an artificial biofilm and the wound was stitched.In the control group,no material was implanted in bone defect after cyst excision.It should inject postoperative antibiotics 3 days and use Yikou Gargle to rinse mouth,stitches 7-10 days after operation.The patients were followed up for 3 months and 6 months after operation and taken OPG and CBCT.(3)Imagine analysis:?It used the Adobe Photoshop to measure the gray value of the bone defect area of OPG and CBCT.It selected sagittal plane,coronal plane and transverse plane of CBCT as the measurement plane.Each image should be measured the gray value of bone defect area and the blank area.The actual gray value is the number of subtraction.Each image measures times and takes the average value of the three measurements.? The changes of the bone defect area in the experimental group and the control group were measured.The sagittal,coronal and cross section of the CBCT in the bone defect area were adjusted to measure the vertical length and horizontal length of the experimental group and the control group at 3 months and 6 months according to the standard defined bone defect.The average length of the vertical line and the horizontal line of the same section(for example,both sagittal planes)of the experimental group and the control group were compared.Compared with the preoperative,the greater the gap,the faster the osteogenesis is.To avoid errors,each data is measured three times by the same person,whichever is the average(4)Statistical analysis:Using spss17.0 statistical software analysis,all imaging data were measured using t test.Two groups of gender,cyst site,cyst type comparison using chi-square test,age and cyst size using nonparametric rank sum test.The test level was bilateral ? = 0.05,p<0.05,the difference was statistically significant.ResultsClinical data analysis:There was no significant difference in sex,age,cyst site,cyst type and cyst area between the experimental group and the control group(p>0.05).(1)The anylasis of OPGThe mean gray value of the bone defect area of the experimental group 3 months after opration was84.34±2.97,and the average gray value of the control group was 15.86±2.70.The experimental group was higher than the control group.By statistical analysis,p<0.05,the two groups were significantly different.The mean gray value of the bone defect area of the experimental group 6 months after opration was 90.88±2.44,and the average gray value of the control group was 36.399±3.86.The experimental group was higher than the control group.By statistical analysis,p<0.05,the two groups were significantly different.(2)The anylasis of gray value of different sections of CBCT?Coronal plane of CBCT(???):The mean gray value of the bone defect area of the experimental group 3 months after opration was 86.91±12.44,and the average gray value of the control group was 17.83±2.96.The experimental group was higher than the control group.By statistical analysis,p<0.05,the two groups were significantly different.The mean gray value of the bone defect area of the experimental group 6 mouths after opration was 91.58±2.96,and the average gray value of the control group was 37.01±2.35.The experimental group was higher than the control group.By statistical analysis,p<0.05,the two groups were significantly different.?Sagittal plane of CBCT(???):The mean gray value of the bone defect area of the experimental group 3 months after opration was 84.91±3.91,and the average gray value of the control group was 16.48±2.85.The experimental group was higher than the control group.By statistical analysis,p<0.05,the two groups were significantly different.The mean gray value of the bone defect area of the experimental group 6 months after opration was 90.75±2.85,and the average gray value of the control group was 35.87±2.41.The experimental group was higher than the control group.By statistical analysis,p<0.05,the two groups were significantly different.?Transverse plane of CBCT(???):The mean gray value of the bone defect area of the experimental group 3 months after opration was 85.01±2.73,and the average gray value of the control group was 16.34±3.46.The experimental group was higher than the control group.By statistical analysis,p<0.05,the two groups were significantly different.The mean gray value of the bone defect area of the experimental group 6 months after opration was 91.76±2.81,and the average gray value of the control group was 36.03±3.04.The experimental group was higher than the control group.By statistical analysis,p<0.05,the two groups were significantly different.(3)Analysis of the mean value of the difference between the vertical length and the horizontal length of CBCT?Coronal plane CBCT:Before operation,the average vertical length of the experimental group was 19.49 ± 2.21mm,the control group was 19.63 ± 2.34mm,the t value was-0.770,p>0.05,there was no significant difference between the two groups.Three months after operation,the average length of the experimental group was 17.15 ± 2.66mm,the control group was 19.23 ± 3.05mm,the t value was-26.732,p<0.05,the two were significantly different.Six months after operation,the mean vertical length of the experimental group was 15.31 ± 3.37mm,the control group was 18.23 ± 3.19mm,the t value was-21.236,p<0.05,the two were significantly different.Before operation,the mean level of the experimental group was 17.65 ± 2.06mm,the control group was 17.85 ± 2.31mm,the t value was-0.859,p>0.05,there was no significant difference between the two groups.Three months after operation,the average level of the experimental group was 15.33 ± 2.22mm,the control group was 17.46 ± 3.58mm,the t value was-26,532,p<0.05,the two were significantly different.Six months after operation,the average level of the experimental group was 13.27 ±3.56mm,the control group was 16.13 ± 3.59mm,the t value was-24.937,p<0.05,the two were significantly different.? sagittal plane CBCT:Before operation,the average vertical length of the experimental group was 19.45 ± 2.06mm,the control group was 19.18 ± 2.47mm,the t value was 5.091,p>0.05,there was no significant difference between the two.Three months after operation,the mean vertical length of the experimental group was 17.50± 2.85mm,the control group was 18.23 ± 3.02mm,the t value was-36.634,p<0.05,the two were significantly different.Six months after operation,the mean vertical length of the experimental group was 16.52 ± 3.44mm,the control group was 17.95 ±3.20mm,the t value was-31.389,p<0.05,the two were significantly different.Before operation,the mean level of the experimental group was 17.45 ± 2.06mm,the control group was 17.65 ± 2.47mm,the t value was-0.862,p>0.05,there was no significant difference between the two groups.Three months after operation,the average level of the experimental group was 16.08 ± 2.66mm,the control group was 17.23 ± 3.05mm,the t value was-32.388,p<0.05,the two were significantly different.Six months after operation,the mean level of the experimental group was 14.31 ±3.37mm,the control group was 16.23 ± 3.19mm,the t value was-27.628,p<0.05,the two were significantly differe?cross section CBCT:Before operation,the mean vertical length of the experimental group was 12.49 ± 2.32mm,the control group was 12.63 ± 2.51mm,the t value was-0.789,p>0.05,there was no significant difference between the two groups.Three months after operation,the average vertical length of the experimental group was 10.52 ± 2.44mm,the control group was 12.01 ± 3.03mm,the t value was-29.327,p<0.05,the two were significantly different.Six months after operation,the mean vertical length of the experimental group was 9.31 ± 3.43mm,the control group was 11.25 ± 3.21mm,the t value was-27.005,p<0.05,the two were significantly different.Before operation,the mean level of the experimental group was 13.52 ± 2.14mm,the control group was 13.65 ± 2.31mm,the t value was-0.715,p>0.05,there was no significant difference between the two groups.Three months after operation,the average level of the experimental group was 11.37 ± 2.23mm,the control group was 12.86 ± 3.54mm,the t value was-29.529,p<0.05,the two were significantly different.Six months after operation,the mean level of the experimental group was 9.58 ±3.66mm,11.13 ± 3.44mm in the control group and the t value was-29.899,p<0.05,there was significant difference between the two groups.ConclusionThis study shows that CGF combined with guided bone generation technology paly a role of promoting bone formation,and it is also better than relying solely on the autologous hematopotetic repair.The bone formation in bone defect is faster,tissue healing and late recovery of repair fuctions is more conductive. |
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