快速成型钛板结合自体骨移植修复犬下颌骨缺损  

Rapid prototyped titanium plate combined with autologous cancellous bone graft repairs canine mandibular defects

作　　者：周丽斌[1] 吴玮[1] 王佩林[1] 丁瑞英[1] 韩浩伦[1] 李保卫[1] 王刚[1] 王鸿南[1] 赵晋龙 刘彦普 

机构地区：[1]解放军第306医院耳鼻咽喉头颈外科,北京市100101 [2]解放军第四军医大学口腔医院口腔颌面外科,陕西省西安市710032

出　　处：《中国组织工程研究》2014年第15期2403-2408,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:近年来,快速成型技术被迅速的应用于医学重建领域,利用快速成型技术可为组织缺损患者制作个体化的植入物,可达到空间尺寸上的精确修复。目的:利用快速成型技术制作个体化钛板,结合自体松质骨移植,修复犬下颌骨节段性缺损。方法:9只杂种犬行螺旋CT扫描获取头颅骨骼数据,建立数字3D模型,在模型上模拟右侧下颌骨体部切除术,并制作个体化板状修复体,经快速成型加工制造,获得个体化的钛板。然后行动物实验,手术制造右侧下颌骨体部4 cm长节段性缺损,同期手术切取自体髂骨块固定于快速成型钛板的舌侧,修复下颌骨缺损。采用核医学、力学、影像学和组织学等方法评估骨移植后的转归。结果与结论:应用快速成型支架重建了左右对称的下颌骨形态,自体髂骨移植后逐渐皮质化,植骨和钛板之间形成纤维结缔组织间隔层。在下颌骨缺损修复中,应用快速成型钛板能够达到形态和功能兼顾的效果。BACKGROUND：Rapid prototyping technique has been recently applied in the medical reconstruction and al ows the production of individual implant for patients with tissue defects, achieving an accurate repair. OBJECTIVE：To repair discontinuous mandibular defects in dogs using rapid prototyped titanium plate in combination with autologous cancellous bone graft. METHODS：Nine hybrid canines were used, and the skul was scanned using spiral CT. Then CT data were used to construct three-dimensional digital model, in which virtual partial mandibulectomy was performed, and an individualized bone-grafting plate was designed. A titanium plate was manufactured using rapid prototyping and titanium casting. Animal experiment was then performed. A 40-mm discontinuous defect in the right mandibular body was created in the involved dogs. The defect was restored immediately using the customized plate in combination with autologous cancellous iliac blocks. Sequential radionuclide bone imaging, biomechanical testing, three-dimensional microcomputed tomographic scanning, radiology and histological examination were used to evaluate the turnover of the grafts. RESULTS AND CONCLUSION：A symmetric mandible was reconstructed using the rapid prototyped grafting plate. The grafted bone survived and got corticalized, while a fibrous intermedium was found between the bone graft and the plate. In the reconstruction of mandibular defects, optimal functional and aesthetic outcomes could be achieved using the rapid prototyped grafting plates.

关 键 词：组织构建 骨组织工程 下颌骨缺损 钛板 髂骨移植 计算机辅助设计 快速成型 核素骨显像 修复体 

分 类 号：R318[医药卫生—生物医学工程]