牵张成骨中植入物的临床应用特点

目的:阐述在领骨的牵张成骨过程中植入物的临床应用进展,并评价其生物相容性.方法:检索者为第一作者,分别以"颌骨,牵张成骨,治疗"和"Jaw,distraction osteogenesis,treatment"为检索词,在中国期刊全文数据库(CNKI:1989/2009)和Medline database数据库(1989/2009),采用电子检索的方式进行文献检索,共检索到56篇文章,按纳入和排除标准对文献进行筛选,共纳入20篇文章.从牵张成骨的治疗进展进行总结,对牵张成骨植入物的临床应用进展进行探讨.结果:牵张成骨植入物分为口内牵张器和口外牵张器,可进行转移盘的牵引.牵张器的选择应根据患者颅面骨具体情况而定,并符合患者的需要.牵张成骨己成为国内外口腔腔面外科及正畸处理诸多复杂牙颌面畸形、颌骨缺损等的重要手段.其与各种全身治疗、局部治疗和物理治疗等的联合应用可更有效的发挥成骨作用.目前牵张成骨植入物主要由金属材料构成.金属植入物在预防细菌滋生,保证植入物的牢固及牵引效应的发挥方面有很大优势,价格普遍昂贵.其中镍钛要忆合金丝成本较一般成品牵引器低的多.其固定装置及合金丝紧贴骨面,可完全植入组织内,且具有抗感染,可完全关闭内外伤口等优点.结论:牵张成骨是临床治疗牙颌面发育不足排齐牙齿及整复颌骨缺损畸形的行之有效的新方法. 金属材料植入物如植入小型的镍钦记忆合金丝的生物相容性较好.其他类型植入物的生物相容性有待提高.

Clinical application characteristics of distraction osteogenesis implants

OBJECTIVE: To investigate the progress of clinical application of implant during distraction osteogenesis in the jaw bones, and to evaluate its biocompatibility.METHODS: The first author retrieved CNKI database from 1989 to 2009 in Chinese and Medline database from 1989 to 2009 in English with the key words of "jaw, distraction osteogenesis, treatment". A total of 56 articles were screened according to inclusion and exclusion criteria. Finally, 20 articles concerning treatment progress of distraction osteogenesis and clinical application of implant were included.RESULTS: Distraction osteogenesis implants contained intraoral or extraoral distraction device, which could be used for distraction of transport plate. A distraction was selected in accordance with patients' condition and requirement. Distraction osteogenesis had been an important manner for complicated tooth jaw facial deformity and jaw defect in oral dentofacial surgery and Orthodontic treatment. It could have effective osteogenesis in combination with various systemic therapy, local therapy and physical therapy. Presently, distraction osteogenesis implants were metal materials. Metal implants have great advantages in preventing bacterium growth, keeping implant fixation and distraction effects, and the price was high. However, the cost of Ni-Ti memory alloy wire was lower compared with common retractors. The fixing device and alloy wire closely adhered to the bone could be completely implanted into tissues, with the advantages of anti-infection and completely closing the exterior and interior wound. CONCLUSION: Distraction osteogenesis is a new method for treating dental and craniofacial hypodevelopment straightening of teeth and for repairing jaw bone defect deformation. Biocompatibility of metal implants was good such as internal small Ni-Ti memory alloy wire. The biocompatibility of other types of implants should be improved.