壳聚糖复合材料修复口腔颌面组织缺损的研究进展

Research progress of chitosan composite material in repairing oral and maxillofacial tissue defects

炎症、外伤、肿瘤等原因导致的口腔颌面部组织缺损,常导致诸如进食困难、咀嚼困难、语言障碍等功能障碍。由于解剖位置的特殊性,口腔颌面部组织缺损还会影响美观,长期不修复可能导致患者心理障碍及人格方面的改变。自体组织移植虽然是修复组织缺损的黄金标准,但可供移植的部位有限,且会造成原来健康部位的损伤,这些因素都限制了自体组织移植的应用。壳聚糖是一种广泛存在于自然界中,可生物降解的阳离子多糖,其化学结构和生物学行为与骨和牙齿的细胞外基质成分相似,是制备有机-无机复合材料的理想模板。优秀的生物相容性、抗菌性使其常作为金属表面涂层应用于牙体种植领域。此外,近年来壳聚糖还被制成盖髓剂、义齿粘接剂等用以保护牙髓,修复牙体组织的缺损或缺失。但单纯壳聚糖材料的脆性大、韧性差,壳聚糖复合材料制成的组织工程支架、涂层、生物膜、水凝胶等丰富了其修复口腔颌面组织缺损的范围。近几年,不同形式的壳聚糖复合材料已经被应用于口腔颌面组织修复中。本文就目前研究成果做一综述,以期找到更适宜临床推广的修复方式。

Oral and maxillofacial tissue defects caused by inflammation,trauma,tumor and other reasons often lead to dysfunctions such as difficulty in eating and chewing,and language disorders.Due to the particularity of the anatomical location,oral and maxillofacial tissue defects will also affect the appearance,and long-term failure ofrepair may cause psychological disorders and personality changes in patients.Although autologous tissue transplantation is the gold standard for repairing tissue defects,there are limited areas available for transplantation,and it will cause damage to the original healthy parts.These factors limit the application of autologous tissue transplantation.Chitosan is a biodegradable cationic polysaccharide that is widely found in nature.Its chemical structure and biological behavior are similar to those of the extracellular matrix of bones and teeth.It is an ideal template for preparing organic-inorganic composite materials.Excellent biocompatibility and antibacterial properties make it often used as a metal surface coating in the field of dental implants.In addition,in recent years,chitosan has also been made into pulp-cap,denture adhesives,etc.to protect the pulp and repair the defects or lack of dental tissue.However,simple chitosan materials are brittle and poor in toughness.The tissue engineering scaffolds,coatings,biofilms,and hydrogels made of chitosan composite materials enrich the scope of repairing oral and maxillofacial tissue defects.In recent years,different forms of chitosan composite materials have been used in the restoration of oral and maxillofacial tissues.This article reviews the current research results in order to find a more suitable repair method for clinical promotion.