下颌骨缺损重建的应用与进展

发布时间：2018-06-04 17:31

本文选题：下颌骨 + 骨重建　；参考：《中国组织工程研究》2017年28期

【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。
[Abstract]:Background: at present, there are a variety of repair methods can be used in clinical mandibular reconstruction, but there are still some problems to be solved in the process of restoration. Objective: to summarize the methods and progress of mandibular defect reconstruction, and to look forward to the development direction of mandibular defect reconstruction. Methods: the first author searched the literature about mandibular defect reconstruction from 1985 to 2017 in PubMed database, Wanfang database and CNKI database. The Chinese key words were "mandibular reconstruction; bone tissue engineering; prosthetic device; complications of the operation area"; and the Chinese key words were "mandibular reconstruction; bone tissue engineering; prosthetic device; complications of the operation area", and the Chinese key words were "mandibular reconstruction; bone tissue engineering; prosthetic device; operative area complication". This paper summarizes the classification and reconstruction methods of mandibular defects, and discusses the problems and future development of mandibular reconstruction. Results and conclusion: the mandibular defects included in 48 references were complicated, and the reasonable classification of mandibular defects was the key to the reconstruction and clinical treatment of mandible. Rapid repair is more conducive to facial shape and functional recovery, and has gradually gained recognition. At present, the commonly used methods for reconstruction of mandibular defects include non-vascularized bone transplantation and vascularized bone transplantation, but the surgical trauma is great and complications occur. Difficult to restore occlusal reconstruction is a difficult problem for clinicians. The emergence of rapid prototyping, computer-aided design and manufacturing technology has not only achieved the accuracy of the operation, but also significantly shortened the operation time. The technique of tissue engineering has a broad application prospect in the reconstruction of mandibular defect. The combination of the technique of computer aided design and manufacture can realize the functional and morphological restoration of mandible. However, the evaluation of long-term effect of large mandibular defects still needs further study.
【作者单位】：广西医科大学附属口腔医院口腔颌面外科;
【基金】：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)~~
【分类号】：R782

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