钛网成型复合自体颗粒骨移植重建下颌骨缺损的实验研究

目的研究钛网成型复合自体颗粒骨移植重建下颌骨节段性缺损的成骨情况。方法7只Beagle犬,在一侧下颌骨制备长4.0 cm的节段性缺损。用钛网成型重建下颌节段性缺损,钛钉固定。将切除后的下颌骨和髂骨剪成直径约2 mm颗粒,紧密充填在钛网内。术后6个月进行下颌骨X线片、组织学切片和扫描电镜观察。结果移植的颗粒骨成骨良好,未见明显吸收,形成成熟的骨结构,与下颌骨断端形成一个牢固的整体。结论钛网成型复合自体颗粒骨移植成骨良好,重建后的下颌骨外形满意,能够提供满足义齿修复和种植义齿所需的牙槽突高度和宽度。     

钛网成型复合自体颗粒骨移植修复下颌骨缺损动物实验的组织学研究

目的研究钛网成型复合自体颗粒骨移植重建下颌骨节段性缺损的组织学变化。方法5只Beagle犬,每只动物一侧下颌骨制备长3.5cm的节段性缺损。用钛网成型重建下颌骨外形,钛钉固定。将切除的下颌骨块和髂骨剪成直径约2mm颗粒,将皮质骨和松质骨混合(按体积比约为3:1),并紧密充填在钛网内。术后6个月取移植骨做组织学检查,包括HE染色、硬组织切片荧光观察和Van-Gieson染色。结果移植骨的表层由多层平行排列的板层骨构成,板层骨皮质骨较薄,孔隙较多。板层骨下方移植骨内部呈现为众多粗大的小梁骨相互融合成网状结构,网状结构内部可见大量排列有序较致密的骨单位。结论钛网成型自体颗粒骨移植能够形成良好的骨组织学结构,有利于种植体植入,修复下颌骨节段性缺损的咬合功能。     

自体骨移植与生物材料修复下颌骨缺损的比较

目的：用组织学观察的方法及分析植入材料在成骨过程中的骨动力学变化比较自体骨移植和胶原羟基磷灰石植入修复下颌骨缺损的效果。方法：本实验将自体骨、胶原羟基磷灰石分别植入10头中国试验用小型猪下颌骨缺损内，采用常规组织学观察，测量并统计基本的骨动力学参数，从定量、动态的角度，研究分析各自在修复过程中骨生长情况。结果：胶原羟基磷灰石植入后比自体骨植入后骨再建发生早，说明前者也具有良好的成骨作用，可较早地促进新生骨生长。结论：胶原羟基磷灰石、自体骨修复下颌骨缺损，其前者可以免除患者自体二处手术供骨的痛苦及心理负担，优于自体骨移植修复，便于临床推广、应用。     

自体骨移植修复下颌骨缺损的研究新进展

自体骨移植是下颌骨缺损最常用的修复方法。为了寻找理想的自体骨源，近年来人们进行了积极探索。     

钛网结构即刻修复下颌骨缺损

目的：探讨钛网结构在口腔颌面外科手术后即刻修复下颌骨缺损的临床应用技术。方法：临床使用钛网结构修复下颌缺损共19例,经9个月－3年随访,并与同期使用不锈钢板修复的15例作对照。结果：19例中有17例术后切口一期愈合,口腔功能恢复较好,生存质量较大提高;2例出现感染,创口延期愈合,其中1例行钛网取出。结论：该技术操作方便,近远期效果满意,是一种较好的下颌骨缺损即刻修复方法。     

下颌骨缺损自体骨移植术后种植修复

目的：下颌骨缺损自体骨移植术后采用种植义齿修复。方法：6例髂骨移植患者，3例直接植入种植体；2例经颌骨骨块上置法植骨后植入种植体；1例经牵引成骨术增高牙槽突后植入种植体。2例腓骨移植患者，分别经腓骨上置法移植和牵引成骨术增高牙槽突后植入种植体。结果：8例患者最终都植入种植体，其中3例已完成上部义齿修复。结论：下颌骨缺损自体骨移植术后，常有牙槽突骨量不足，需行牙槽突Ⅱ期重建。上置法植骨和牵引成骨术能成功地重建牙槽突缺损骨量。     

自体骨移植修复下颌骨缺损的研究新进展

自体骨移植是下颌骨缺损最常用的修复方法。为了寻找理想的自体骨源,近年来人们进行了积极探索。自体血管化腓骨、自体松质细胞骨、自体颅骨、自体冷冻病变下颌骨和自体脱钙骨等修复下颌骨缺损的效果良好,但也存在各自的优缺点。     

自体肋骨移植修复下颌骨缺损

总结应用自体肋骨移植修复下颌骨缺损经验。方法 采用自体肋骨即时作下颌骨缺损修复共３８例。结果 ３８例植骨均成活，成功率１００％，术后钼菜良好，其中２０例术后作义齿修复，功能良好。结论自体肋骨修复良性肿瘤切除后的下颌骨缺损，特别是４５岁以下青壮年成功率高。     

血管化骨移植修复下颌骨缺损的研究

下颌骨的修复问题一直吸引着广大头颈外科医师进行不断地探索和研究,下颌骨的修复既要求有良好的外形,又要求能较好地恢复咀嚼、发音、吞咽等口腔功能。早在１８６０年Ｏｌｉｖｅｒ就对骨再生及骨移植等问题进行了探讨,之后相继出现了异种骨、异体骨、自体骨及人工骨移...     

钛支架联合髂松质骨片修复下颌骨缺损14例报告

下颌骨形态功能复杂,在颌面骨组织缺损中最为多见,外伤,肿瘤手术或炎症等均可造成大范围的骨质缺损,功能修复比较困难,目前主要采用骨移植或代用品重建,我们近年来采用钛板作支架,联合自体松质骨片即刻修复下颌骨缺损14例,结果满意。     

钛网成型自体颗粒骨复合骨修复材料修复兔下颌骨缺损的实验研究

目的:评价钛网成型自体颗粒骨复合骨修复材料移植重建兔下颌骨节段性缺损的成骨效果.方法:18只新西兰家兔,均建立单侧下颌骨节段性缺损模型,随机分为3组,用钛网成型重建下颌骨外形后,分别移植自体颗粒骨、骨修复材料和自体颗粒骨复合骨修复材料.术后12周取移植骨做组织学检查及Micro-CT检查.应用SPSS 14.0软件包对...     

CAD/CAM制作个性化钛网联合髂骨移植重建单侧下颌骨大型轮廓缺损

目的 探讨CAD/CAM技术联合个性化预成型钛网及游离髂骨移植修复单侧下颌骨大型轮廓缺损的可行性及有效性.方法 选取四川大学华西口腔医院正颌及关节外科2015年11月—2019年12月的15例单侧下颌骨大型轮廓缺损的患者.采用基于逆向工程的计算机辅助设计/计算机辅助制作(CAD/CAM)技术,镜像重建患侧下颌骨轮廓并制...     

Vertical alveolar ridge augmentation by means of a titanium mesh and autogenous bone grafts

The aim of this study is to evaluate a surgical protocol for vertical ridge augmentation in the maxilla and mandible using autogenous onlay bone graft associated with a titanium mesh. A group of 18 partially edentulous patients, presenting the need for vertical bone augmentation of at least 4 mm, were treated before implant placement. During the first surgery, an autogenous bone graft was harvested from either the mandibular ramus or the mental symphysis and secured by means of titanium screws. Particulate bone was added and a titanium micro-mesh was used to stabilize and protect the graft. After a mean interval of 4.6 months, meshes and screws were removed and 37 endosseous implants were successfully placed. The desired bone gain was reached in all patients. Mean vertical bone augmentation obtained was 4.8 mm (range 4-7 mm). No major complications were recorded at recipient or donor sites. Abutment connection was carried out 2-3 months after implant placement. No implant was lost. Clinical parameters and probing depth, after prosthetic reconstruction, demonstrated the presence of a healthy peri-implant mucosa. The preliminary results suggest that, by using the presented technique, patients can be successfully rehabilitated by means of implant-supported prosthesis 6-7 months after the first surgery, even in case of severely atrophied maxilla.     

Alveolar ridge reconstruction with titanium mesh and autogenous particulate bone graft: computed tomography-based evaluations of augmented bone quality and quantity

Purpose: The purpose of this study was to evaluate the quality and quantity of augmented bone following alveolar ridge reconstruction with titanium mesh and autogenous particulate bone graft for implant placement in terms of the preoperative bone defect. Materials and Methods: Forty‐one patients (50 sites) rehabilitated between September 2000 and May 2009 with autogenous particulate intraoral bone or iliac cancellous bone marrow grafts and micro‐titanium meshes were enrolled. We classified the bone defects by means of shape as complex horizontal–vertical (HV), horizontal (H), and socket (S) types, and the augmented bone was evaluated based on preoperative computed tomographic data. The postsurgical complications were assessed during the healing period and after implant superstructure placement. Results: The bone defects were successfully augmented using the titanium mesh technique. The HV‐type defect was the most difficult to augment (mean horizontal gain, 3.7 ± 2.0 [SD] mm; mean vertical gain, 5.4 ± 3.4 [SD] mm). The mean horizontal gain with the H‐type defect was 3.9 ± 1.9 mm. The S‐type defect achieved the most efficient bone augmentation (mean horizontal gain, 5.7 ± 1.4 [SD] mm; mean vertical gain, 12.4 ± 3.1 [SD] mm). The major postsurgical complications were mesh exposure, infection, total or partial bone resorption, and temporary neurological disturbances. Implant failure was observed in one case. The HV‐type defect showed significantly higher bone resorption (p < .05) than the other defect types. Conclusions: Autogenous bone grafting with titanium mesh allows adequate vertical and horizontal alveolar bone reconstruction both quantitatively and qualitatively for implant placement. However, the clinical outcome of augmentation depends on the type of preoperative bone defect.     

The effect of hyperbaric oxygen treatment on bone tissue reactions to c.p. titanium implants placed in free autogenous bone grafts. A histomorphometric study in the rabbit mandible.

This study aimed to investigate the effect of hyperbaric oxygen (HBO) therapy on the tissue reactions to commercially pure (c.p.) titanium implants placed in free autogenous bone graft by a 1-stage procedure. Eighty c.p. titanium implants were placed in the bone grafted from iliac crest to bilateral mandible of 40 Japanese white rabbits without tapping. Twenty rabbits underwent daily a HBO treatment for 60 min under 2.4 ATA during 20 consecutive days and the other untreated 20 rabbits served as controls. The implants with surrounding bone tissue were retrieved 20, 30, 60, 90 and 120 days after surgery, fixated, dehydrated and embedded in resin. About 20 microns thick ground sections were prepared prior to microscopical observations. The bone area and the bone-to-implant contact inside the threads were calculated separately in the grafted bone and in the host bone for each implant. After 30 and up to 120 days, the HBO treated group showed more bone-to-implant contacts in the grafted bone as compared to the non-HBO treated group. In the host bone there were no differences observed between HBO and non-HBO treated groups. This study indicated that HBO treatment was beneficial for the tissue incorporation of c.p. titanium implants when placed immediately in free autogenous bone grafts.     

The effect of hyperbaric oxygen treatment on bone tissue reactions to c.p. titanium implants placed in free autogenous bone grafts. A histomorphometric study in the rabbit mandible.

This study aimed to investigate the effect of hyperbaric oxygen (HBO) therapy on the tissue reactions to commercially pure (c.p.) titanium implants placed in free autogenous bone graft by a 1‐stage procedure. Eighty c.p. titanium implants were placed in the bone grafted from iliac crest to bilateral mandible of 40 Japanese white rabbits without tapping. Twenty rabbits underwent daily a HBO treatment for 60 min under 2.4 ATA during 20 consecutive days and the other untreated 20 rabbits served as controls. The implants with surrounding bone tissue were retrieved 20, 30, 60, 90 and 120 days after surgery, fixated, dehydrated and embedded in resin. About 20 μm thick ground sections were prepared prior to microscopical observations. The bone area and the bone‐to‐implant contact inside the threads were calculated separately in the grafted bone and in the host bone for each implant. After 30 and up to 120 days, the HBO treated group showed more bone‐to‐implant contacts in the grafted bone as compared to the non‐HBO treated group. In the host bone there were no differences observed between HBO and non‐HBO treated groups. This study indicated that HBO treatment was beneficial for the tissue incorporation of c.p. titanium implants when placed immediately in free autogenous bone grafts.     

钛网加强的BMSC/松质骨基质修复下颌骨缺损的实验研究

目的：观察钛网加强的骨髓基质细胞(BMSC)／松质骨基质复合物修复下颌骨缺损的能力。方法：体外培养兔BMSC经扩增，诱导分化后复合同种异体松质骨基质，植入自体下颌骨缺损区，修复骨缺损，钛网固位和加强，植入6周、12周后经X线，组织学检查，观察骨形成情况。结果：骨髓基质细胞(BMSC)/松质骨基质复合物有很强的成骨作用，实验组X线观察有骨形成，组织学染色证实有新骨形成，骨磨片显示钛网和新骨获得良好的愈合。结论：钛网加强的BMSC／松质骨基质可诱导修复兔下颌骨缺损，为组织工程方法修复骨缺损提供了新的思路。