构建预制个性化骨瓣修复下颌骨缺损的灵长类动物模型  

Establishment of a primate animal model of mandibular reconstruction with the prefabricated, customized bone flaps

作　　者：周苗[1,2] 彭歆[2] 车月娟[3] 毛驰[2] 胡敏[4] 俞光岩[2] 

机构地区：[1]广州医科大学附属口腔医院口腔颌面外科.口腔医学院.广州口腔疾病研究所,广东省广州市510140 [2]北京大学口腔医院口腔颌面外科,北京市100081 [3]中山大学孙逸仙纪念医院麻醉科,广东省广州市510120 [4]解放军总医院口腔颌面外科,北京市100853

出　　处：《中国组织工程研究》2014年第18期2812-2817,共6页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金(81000421);ITI基金(0847_2012);北京市科委重大项目(D090600704040291)~~

摘　　要：背景:预制个性化骨瓣具有创伤小、血运好、可带软组织、形状可定制等优点,可用来修复血管床欠佳的骨缺损。目的:建立预制骨瓣修复灵长类下颌骨缺损的动物模型。方法:对9只恒河猴进行头颅扫描并制作个性化钛网。将复合或者未复合人重组骨形态发生蛋白2的脱钙冻干骨、珊瑚装入个性化钛网,植入背阔肌中进行个性化、血管化组织工程骨瓣的预制或者原位植入下颌骨节段性缺损。13周时,个性化、血管化组织工程骨瓣预制成功,将其转移修复下颌骨节段型缺损。采用临床和组织学方法观察异位预制个性化骨瓣及原位植入人重组骨形态发生蛋白2修复下颌骨缺损的效果。结果与结论:预制骨瓣和原位植入的复合人重组骨形态发生蛋白2的珊瑚能修复下颌骨节段性缺损;原位植入复合或未复合人重组骨形态发生蛋白2的脱钙冻干骨和单纯珊瑚不能修复下颌骨缺损。复合人重组骨形态发生蛋白2的脱钙冻干骨、珊瑚预制个性化、血管化组织工程骨瓣成功,转移后均能成功修复下颌骨缺损,而且修复下颌骨缺损的效果优于材料直接植入下颌骨缺损组。实验证实预制个性化骨瓣修复恒河猴下颌骨缺损模型是可行的。BACKGROUND：Prefabricated customized bone flaps have the advantages of few trauma, good vascularization, ossification with predetermined shape, and can be used to restore bone defects with compromised blood bed. OBJECTIVE：To establish animal models of mandibular reconstruction with prefabricated, customized bone flaps. METHODS：After computed tomography scanning of nine rhesus’ head, customized meshes were made. After loading with recombinant human bone morphogenetic protein-2-incorporated demineralized freeze-dried bone al ograft （DFDBA） or coral ine hydroxyapatite （CHA）, the constructs were implanted in latissimus dorsi muscle. Meanwhile, segmental mandibular defects were created, and the customized meshes loaded with DFDBA, CHA,＆amp;nbsp;or recombinant human bone morphogenetic protein-2-incooperated DFDBA and CHA were implanted in situ. At 13 weeks, prefabricated bone flaps with recombinant human bone morphogenetic protein-2-incorporated DFDBA or CHA were transferred to repair segmental mandibular defects. Clinical and histological analyses were used to evaluate the ossification and vascularization of the prefabricated implants in ectopic and orthotopic sites. RESULTS AND CONCLUSION：Segmental mandibular defects were successful y restored with prefabricated bone flaps and recombinant human bone morphogenetic protein-2-incorporated CHA in situ, but other segmental mandibular defects remained with recombinant human bone morphogenetic protein-2-incorporated DFDBA, DFDBA and CHA in situ. Moreover, mandibles reconstructed with prefabricated bone flaps revealed more regenerated and homogeneous bone formation than other reconstructions. These findings suggest that the animal model of mandibular reconstruction with prefabricated, customized bone in rhesus monkey is applicable.

关 键 词：实验动物 组织构建 颌骨缺损 预制个性化骨瓣 下颌骨重建 人重组骨形态发生蛋白2 国家自然科学基金 

分 类 号：R318[医药卫生—生物医学工程]