中国组织工程研究 ›› 2019, Vol. 23 ›› Issue (15): 2436-2442.doi: 10.3969/j.issn.2095-4344.1157

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

弧形牵张成骨的前景及应用

周  扬,周丽斌,朴正国   

  1. (广州医科大学附属口腔医院颌面外科,广州口腔疾病研究所,口腔医学重点实验室,广东省广州市  510140)
  • 收稿日期:2018-12-25 出版日期:2019-05-28 发布日期:2019-05-28
  • 通讯作者: 周丽斌,博士,副主任医师,广州医科大学附属口腔医院颌面外科,广州口腔疾病研究所,口腔医学重点实验室,广东省广州市 510140
  • 作者简介:周扬,女,1994年生,湖北省十堰市人,汉族,广州医科大学在读硕士。
  • 基金资助:

    北京市科技新星计划项目(Z161100004916140),项目负责人:周丽斌

Prospects and application of curvilinear distraction osteogenesis

Zhou Yang, Zhou Libin, Piao Zhengguo   

  1.  (Department of Maxillofacial Surgery, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou Institute of Oral Disease, Key Laboratory of Oral Medicine, Guangzhou 510140, Guangdong Province, China)
  • Received:2018-12-25 Online:2019-05-28 Published:2019-05-28
  • Contact: Zhou Libin, MD, Associate chief physician, Department of Maxillofacial Surgery, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou Institute of Oral Disease, Key Laboratory of Oral Medicine, Guangzhou 510140, Guangdong Province, China
  • About author:Zhou Yang, Master candidate, Department of Maxillofacial Surgery, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou Institute of Oral Disease, Key Laboratory of Oral Medicine, Guangzhou 510140, Guangdong Province, China
  • Supported by:

    the Beijing Science and Technology New Star Project, No. Z161100004916140 (to ZLB)

摘要:

文章快速阅读:

文题释义:
弧形牵张器:临床上传统的直线式牵张器难以适应颌骨形态和功能需要,因而设计出适合颌骨外形的弧形牵张成骨装置,通过连接骨转移盘的滑块沿弧形轨道滑行产生牵引力,使生成的新骨呈弧形更加接近颌骨的轮廓形态,从而恢复颌骨的缺损。
颌骨重建:由于外伤、肿瘤切除及先天畸形等原因造成颌骨缺损可严重影响患者颜面部外形,影响咀嚼、发音等功能,通过牵张成骨、骨移植手术等方式修复患者颌骨外形缺损,恢复其咀嚼、语音等功能和提高生存质量。
摘要
背景:
颅颌面骨发育不足和颌骨缺损是颌面外科临床中经常面临的病症,如何修复始终是一个难题。近年来牵张成骨已成为矫治颌骨发育不足及修复骨缺损的一种有效手段。由于牵张成骨技术具有创伤小、避免植骨、周围软组织同步得以延长等优点,其在增加牙槽骨骨量、延长颌骨、修复骨缺损、关闭骨缺隙等应用中具有其他方法不可替代的优势。
目的:总结并讨论各种弧形牵张器的技术方法和应用、局限性以及未来发展趋势。
方法:检索中国期刊全文数据库(CNKI)、万方数据、PubMed及Embase等数据库和国家知识产权局专利检索分析平台2000年1月至2018年10月相关文献,检索词分别为“牵张成骨、曲线牵张、弧形牵引器、重建、研究进展、下颌骨、上颌骨、缺损、个体化牵引器、有限元法”和“Distraction osteogenesis,curvilinear distraction,Curved distractor,Reconstruction,Research progress,Mandibular,Maxilla,defect;Customized disractor,finite element method”。共纳入58篇文献进行分析探讨。
结果与结论:①早期的牵张成骨装置多为外置式单方向的牵张器,随着各项技术的发展,出现了各种了口内牵张器,例如螺旋牵张器、曲线牵张器、双向牵张器、三焦点牵张器以及自动牵张器;②鉴于颌骨特殊的解剖形态,存在多处弧面结构,如下颌角、颏正中联合、上颌牙槽骨等,为了使生成的新骨更加接近颌骨的轮廓形态,弧形(曲线)牵张成骨也逐渐成为研究热点;③尽管现存各种曲线牵张装置为颌骨缺损提供了可靠的技术手段,但其仍存在一定程度的局限性。由于牵引加力方式等问题的存在未能完成真正意义的曲线乃至三维牵张。制定个体化牵张器同时与结合相关创新技术,并向微型、稳定化发展仍是今后曲线牵张相关研究的主流趋势。

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: 0000-0001-8571-0084(周扬)

关键词: 牵张成骨, 曲线牵张, 弧形牵引器, 重建, 下颌骨, 上颌骨, 缺损, 个体化牵引器, 牵引加力方式, 曲线牵引

Abstract:

BACKGROUND: Insufficient development of craniofacial bone and jaw defects are common problems in clinical practice of maxillofacial surgery. How to repair is always a problem. Because distraction osteogenesis has the advantages of small trauma, avoiding bone grafting, and prolonging the synchronization of surrounding soft tissue, it holds critical role in increasing alveolar bone mass, prolonging jaw bone, repairing bone defect, and closing bone gap.
OBJECTIVE: To summarize and discuss the technical methods, application, limitations and development trends of various curved distractors.
METHODS: Relevant articles published from January 2000 to October 2018 were retrieved from CNKI, WanFang, PubMed and Embase databases and National Intellectual Property Office Patent Search and Analysis Platform. The key words were “distraction osteogenesis, curvilinear distraction, curved distractor, reconstruction, research progress, mandibular, maxilla, defect, customized distractor, finite element method” in Chinese and English, respectively. Fifty-eight eligible articles were included for review.  
RESULTS AND CONCLUSION: (1) The early distraction osteogenesis devices are mostly external unidirectional distractors. With the development of various technologies, various intra-oral distractors, such as spiral distractor, curve distractor, bidirectional distractor, three-focus distractor and automatic distractor. (2) In view of the special anatomical shape of the jaw, there are many arc-faced structures. In order to make the new bone closer to the contour shape of the jaw, curved distraction osteogenesis has gradually become a research hotspot. (3) Although the existing curved distractors provide a reliable technical means for jaw defects, they still have a certain degree of limitation. Due to the existence of problems such as traction and force, the true meaning curve and even the three-dimensional distraction are not completed. The development of individualized stretchers combined with relevant innovations, and towards miniaturization and stabilization development is still the mainstream trend of future research on curvilinear distraction.

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: Tissue Engineering, Traction, Surgery, Oral, Mandible, Maxilla

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