个体化三维带种植体中空钛网复合β-磷酸三钙和松质骨髓修复下颌骨节段性缺损

Mandibular defect reconstruction by using individualized three-dimensional titanium mesh combined with beta-tricalcium phosphate and particulate cancellous bone and marrow

背景:前期实验中,课题组已经应用计算机辅助方法成功制备了个体化下颌骨带种植体三维钛网修复体。目的:在前期实验基础上,观察个体化三维带种植体中空钛网复合β-磷酸三钙和松质骨髓修复下颌骨节段性缺损的效果,探讨下颌骨节段性缺损的个体化再生修复途径。设计、时间及地点:单一样本动物体内实验,于2003-09/2006-10在解放军第四一一医院口腔专科中心和解放军第二军医大学长海医院口腔科完成。材料:利用计算机辅助方法自行设计个体化带种植体三维钛网;不规则颗粒型β-磷酸钙生物陶瓷由上海贝奥路生物材料有限公司提供。方法:实验犬6只,全部制备犬下颌骨体部节段性缺损,然后利用预先构建的个体化带种植体三维中空钛网复合β-磷酸三钙和松质骨髓植入对骨缺损进行修复。主要观察指标:通过X射线、大体标本和组织学切片观察,分析和评价个体化再生修复下颌骨节段性缺损的效果。结果:下颌骨解剖形态和连续性恢复十分理想,组织学和X射线观察显示钛网内有新骨形成,新生骨在修复后3个月时已十分明显和成熟。结论:利用计算机辅助方法预构个体化带种植体三维钛网,复合β-磷酸三钙和松质骨髓植入,可望实现下颌骨节段性缺损的个体化再生修复。

BACKGROUND： In previous studies, we have established computer-assisted individualized three-dimensional titanium mesh for reconstruction of mandibular defect. OBJECTIVE： To explore the effect of the reconstruction of mandibular segmental defect by implant of β -tricalcium phosphate （β-TCP and particulate cancellous bone and marrow （PCBM） and to develop a new method of reconstruction of mandibular segmental defect. DESIGN, TIME AND SETTING： Single-sample in vivo experiment was performed at the Stomatological Center, the 411 Hospital of Chinese PLA and Department of Stomatology, Changhai Hospital, Second Military Medical University of Chinese PLA between September 2003 and October 2006. MATERIALS： Computer-assisted reconstruction of individualized three-dimensional titanium mesh was designed by our laboratory; β-TCP biocerarnics was provided by Shanghai Bio-lu Biocemmics. METHODS： Individualized three-dimensional titanium mesh was pre-developed and was used to reconstruct mandibular segmental defe of six dogs combined with PCBM and β-TCP. MAIN OUTCOME MEASURES： X-ray observation and histological examination were employed to assess the effect of bone reconstruction. RESULTS： The formation and succession of the mandible was ideally recovered. New bone formation was seen by both the X-ray observation and the histological examination. Bony union between the dental implant and the new bone were also showed by the X-ray observation. CONCLUSION： It is possible to attain individualized functional reconstruction of mandibular segmental defect using individualized three-dimensional titanium mesh combined with PCBM and β-TCP.