颅骨缺损的组织工程学修复及CAD/CAM数字化成型技术的应用

背景：头颅骨骼解剖结构复杂，曲面变化大，修复要求较高，巨大、复杂部位的颅骨缺损的修复一直是神经外科具有挑战性的课题之一。采用何种修补材料、如何将颅骨缺损修复的更加完美是当前国内外学者研究的热点。 目的：综述组织工程学和CAD/CAM数字化成型技术用于钛合金材料修复头颅损伤的研究。 方法：以tissue engineering，craniocerebral trauma，CAD/CAM和titanium armor plate为检索词，检索Medline数据库(2000/2011-06)，以组织工程，头颅骨损伤，数字化三维成形，钛网为检索词，检索CNKI数据库(1990/2011-06)。将近年发表的针对性强的文章纳入研究范围，同一领域的文献则选择近期发表或权威杂志的文章。排除与传统材料或方法修复头颅骨损伤和陈旧的文献。对查阅到的最新研究及临床应用有实用价值的文献详细分析并加以总结概括。 结果与结论：初次检索到236篇文献，严格按照纳入标准，最终将27篇文献纳入研究。传统方法修复损伤的颅骨常常遇到组织相容性不佳，材料不足，无法随个体生长等问题，极大降低修复体的应用效果，而CAD/CAM数字化成型技术够复制出与患者颅颌骨缺损部位几何形态高度吻合，实现了个体化配置修补颅骨缺损，可形式具有良好生物相融性的钛网颅骨修复体。

Application of tissue engineering repair and computer associated design/computer associated manufacture digital modeling technology in skull defects

BACKGROUND:The surgical reconstruction of extensive skull defect has always been a challenge for neurosurgeon for its complicated anatomical structure and irregular three-dimensional curvature. Choosing the suitable repair material to achieve perfect repairment of skull defect is the hotspot in current research. OBJECTIVE:To summarize the studies on application of concerning tissue engineering and computer associated design/computer associated manufacture (CAD/CAM) digital technology to titanium alloy materials in the repairment of cephalic injury. METHODS:A computer-based online retrieval of Medline database from January 2000 to June 2011 was performed with the key words of “tissue engineering, craniocerebral trauma, CAD/CAM, titanium armor plate” in English, and the retrieval of CNKI database from January 1990 to June 2011 was performed with the key words of “tissue engineering, skull injury, digital three-dimensional modeling, titanium mesh” in Chinese. The highly targeted articles were included. The documents published currently or in the authority journals were preferred in the same field. Studies focused on traditional materials or methods for repairing skull injury and outdated studies were excluded. The latest research and clinical practical studies were summarized in details. RESULTS AND CONCLUSION:A total of 236 documents were obtained in initial retrieval, 27 articles of them were chosen to summarize based on strict inclusion criteria. Traditional methods for repair of skull injury can greatly reduce the effects of restorations because of their poor biocompatibility, lack of materials, and they do not grow with the individual growth. CAD/CAM digital prototyping technology can duplicate the geometrical shape that is highly consistent with the skull and jaw defects to achieve a personalized configuration for repairing skull defects and produce well biocompatible titanium mesh skull prosthesis.