Costello Bernard J, Shah Gaurav, Kumta Prashant, Sfeir Charles S
Division of Craniofacial and Cleft Surgery, Department of Oral and Maxillofacial Surgery, University of Pittsburgh School of Dental Medicine, 3471 Fifth Avenue, Suite 1112, Pittsburgh, PA 15213, USA.
Oral Maxillofac Surg Clin North Am. 2010 Feb;22(1):33-42. doi: 10.1016/j.coms.2009.10.009.
Regenerative medicine has recently seen much activity in basic and translational research. These advances are now making their way into surgical practice. A convergence of technologies has afforded opportunities previously not available with conventional surgical reconstructive techniques. Patients requiring complex reconstructive surgery in the craniomaxillofacial region typically benefit from local or regional flaps, nonvascularized grafts, microvascular tissue transfer, or substitute alloplastic materials to restore function and form. In these clinical situations, grafting procedures or alloplastic substitute materials provide best-case replacements for resected, injured, or congenitally missing tissues. However, ideal reconstructive goals, such as a complete return to original form and function, are frequently not completely achieved. Regenerative techniques now in clinical use and at the translational research stage hold promise for custom-tailored constructs with the potential to regenerate tissue in the host without significant donor site morbidity. These techniques may provide better structure, aesthetics, and function than the best currently available options. This article presents the latest concepts in craniomaxillofacial regenerative medicine and reviews the multipronged approach to restoring architecture using novel "smart" multifunctional scaffolds, cellular technologies, growth factors, and other novel regenerative medical strategies.
近年来，再生医学在基础研究和转化研究方面取得了诸多进展。这些进展如今正逐渐应用于外科手术实践。技术的融合带来了传统外科重建技术所无法提供的机遇。在颅颌面区域需要进行复杂重建手术的患者通常受益于局部或区域皮瓣、非血管化移植物、微血管组织移植或异体替代材料，以恢复功能和外形。在这些临床情况下，移植手术或异体替代材料为切除、受损或先天性缺失的组织提供了最佳替代方案。然而，理想的重建目标，如完全恢复到原始的形态和功能，往往无法完全实现。目前正在临床应用和处于转化研究阶段的再生技术有望实现定制化构建，有可能在宿主中再生组织，且供区并发症轻微。这些技术可能比目前最佳的现有选择提供更好的结构、美学效果和功能。本文介绍了颅颌面再生医学的最新概念，并综述了使用新型“智能”多功能支架、细胞技术、生长因子和其他新型再生医学策略来恢复结构的多管齐下方法。
