中国组织工程研究

中国组织工程研究 ›› 2017, Vol. 21 ›› Issue (28): 4550-4555.doi: 10.3969/j.issn.2095-4344.2017.28.020

• 组织构建综述 tissue construction review • 上一篇    下一篇

下颌骨缺损重建的应用与进展

马 成，黄旋平   

  1. 广西医科大学附属口腔医院口腔颌面外科，广西壮族自治区南宁市  530021
  • 修回日期:2017-08-07 出版日期:2017-10-08 发布日期:2017-11-10
  • 通讯作者: 黄旋平， 硕士生导师，教授，广西医科大学附属口腔医院口腔颌面外科, 广西壮族自治区南宁市 530021
  • 作者简介:马成，男，1991年生，安徽省阜阳市人，回族，广西医科大学在读硕士，主要从事口腔颌面部的研究。
  • 基金资助:

    广西科技攻关计划项目(1598012-18)；广西高校科学技术研究项目(ZD2014035)；广西医疗卫生适宜技术开发与推广应用项目(S201687)

Application and progress of mandibular reconstruction

Ma Cheng, Huang Xuan-ping   

  1. Department of Oral and Maxillofacial Surgery, Stomatological Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
  • Revised:2017-08-07 Online:2017-10-08 Published:2017-11-10
  • Contact: Huang Xuan-ping, Master’s supervisor, Professor, Department of Oral and Maxillofacial Surgery, Stomatological Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
  • About author:Ma Cheng, Studying for master’s degree, Department of Oral and Maxillofacial Surgery, Stomatological Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
  • Supported by:

    the Key Research & Development of Guangxi Zhuang Autonomous Region, No. 1598012-18; the Science and Technology Research of Universities in Guangxi Zhuang Autonomous Region, No. ZD2014035; the Medical and Health Appropriate Technology Development and Promotion Project of Guangxi Zhuang Autonomous Region, No. S201687

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摘要：

文章快速阅读：

文题释义：
计算机辅助设计与制造技术：是以计算机作为主要技术手段，处理各种数字信息与图形信息，从而设计和制造出各种产品。
快速成型技术：是集机械工程、CAD、逆向工程技术、分层制造技术、数控技术、材料科学、激光技术于一身，可以自动、直接、快速、精确地将设计思想转变为具有一定功能的原型或直接制造零件，从而为零件原型制作、新设计思想的校验等方面提供了一种高效低成本的实现手段。

 

摘要
背景：目前有多种修复方法可以应用于临床下颌骨修复重建，但在修复过程依然存在一些问题有待解决。
目的：总结下颌骨缺损重建的方法及进展，面临的难题，展望下颌骨缺损重建的发展方向。
方法：由第一作者用计算机检索PubMed数据库、万方数据库和CNKI数据库1985年至2017年有关下颌骨缺损重建进展的文献，并进行筛选、归纳和总结。英文检索词为“Mandibular reconstruction；bone tissue engineering；prosthesis device；operative complications”，中文检索词为“下颌骨重建；骨组织工程；修复体装置；术区并发症”。从下颌骨缺损的分类、重建方法等方面进行总结，探讨下颌骨重建存在的难题及未来发展方向。
结果与结论：纳入文献48篇。①下颌骨缺损较为复杂，合理的缺损分类是下颌骨修复重建和临床治疗的关键；②对于因肿瘤切除导致的下颌骨缺损，快速修复更有利于面部外形和功能恢复，已逐步获得认可；③目前下颌骨缺损重建的常用方法主要包括非血管化骨移植和血管化骨移植等，但手术创伤大，并发症的发生，难以恢复咬合重建等是困扰临床医生的难题。快速成型技术、计算机辅助设计与制造技术的出现，不仅实现了手术的精确度，还显著缩短了手术时间，使患者获得良好的重建效果；④组织工程技术在下颌骨缺损重建修复方面具有广阔的应用前景，其与计算机辅助设计与制造技术的结合，能够实现下颌骨功能和形态的修复，但是对于大块下颌骨缺损修复的长期效果评估仍需进一步研究。

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程
ORCID: 0000-0001-9291-5985(马成)

关键词: 组织构建, 骨组织工程, 下颌骨缺损, 下颌骨重建, 术区并发症, 计算机辅助设计, 制造技术, 快速成型技术, 骨移植

Abstract:

BACKGROUND: There are various methods used for mandibular reconstruction, but some problems still need to be solved. 
OBJECTIVE: To summarize the methods, research progress, and existing problems of mandibular reconstruction, and forecast the future development.
METHODS: The “mandibular reconstruction, bone tissue engineering, prosthesis device, operative complications” in English and Chinese served as the keywords to search the articles related to the research progress of mandibular reconstruction published from 1985 to 2017 in PubMed, WanFang and CNKI databases. The classification of mandibular defects, reconstruction methods were summarized, and the existing difficulties and development direction were explored.
RESULTS AND CONCLUSION: Totally 48 eligible articles were enrolled. Considering that mandibular defects are complicated, an appropriate classification method is crucial for mandibular reconstruction and treatment. Immediate reconstruction is recommended for mandibular defects caused by tumor resection, which has been shown to be available for the recovery of facial appearance and function. Non-vascularized and vascularized bone grafts are commonly used for mandibular reconstruction, but large surgical trauma, complications and difficulty in occlusal relationship still trouble clinical surgeons. Those emerging technologies, such as rapid prototyping, computer aided design and computer aided manufacture, not only enhance the surgical precision, but also remarkably reduce the operation time, further achieving satisfactory reconstructive effects. Tissue engineering is a promising method in the reconstruction of mandibular defects, and its combination with computer aided design and computer aided manufacture can perfectly restore the mandibular function and morphology. However, the long-term efficacy in the repair of mandibular defects needs to be studied in depth. 

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

Key words: Mandible, Bone Remodeling, Computer-Aided Design, Tissue Engineering

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