Zhou Libin, Wang Peilin, Han Haolun, Li Baowei, Wang Hongnan, Wang Gang, Zhao Jinlong, Liu Yanpu, Wu Wei
Department of Otolaryngology Head and Neck Surgery, The 306th Hospital of PLA, 9 Anxiangbeili Street, Chaoyang District, Beijing 100101, PR China.
Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, 145 Western Changle Road, Xi'an 710032, Shaanxi, PR China.
J Craniomaxillofac Surg. 2014 Dec;42(8):1723-9. doi: 10.1016/j.jcms.2014.06.006. Epub 2014 Jun 13.
To esthetically and functionally restore a 40-mm canine mandibular discontinuity defect using a custom-made titanium bone-grafting plate in combination with autologous iliac bone grafts. Individualized titanium bone-grafting plates were manufactured using a series of techniques, including reverse engineering, computer aided design, rapid prototyping and titanium casting. A 40-mm discontinuous defect in the right mandibular body was created in 9 hybrid dogs. The defect was restored immediately using the customized plate in combination with autologous cancellous iliac blocks. Sequential radionuclide bone imaging was performed to evaluate the bone metabolism and reconstitution of the grafts. The specimens were evaluated by biomechanical testing, 3-dimensional microcomputed tomographic scanning, and histological examination. The results revealed that the symmetry of the mandibles was reconstructed using the customized grafting plate, and the bony continuity of the mandibles was restored. By 12 weeks after the operation, the cancellous iliac grafts became a hard bone block, which was of comparable strength to native mandibles. A fibrous tissue intermediate was found between the remodelled bone graft and the titanium plate. The results indicate that the prototyped grafting plate can be used to restore mandibular discontinuous defects, and satisfactory aesthetical and functional reconstruction can be achieved.
使用定制钛制骨移植板结合自体髂骨移植，从美学和功能上修复40毫米的犬下颌骨连续性缺损。采用包括逆向工程、计算机辅助设计、快速成型和钛铸造在内的一系列技术制造个性化钛制骨移植板。在9只杂种犬的右侧下颌骨体制造一个40毫米的连续性缺损。使用定制板结合自体松质髂骨块立即修复缺损。进行连续放射性核素骨显像以评估移植骨的骨代谢和重建情况。通过生物力学测试、三维显微计算机断层扫描和组织学检查对标本进行评估。结果显示，使用定制移植板重建了下颌骨的对称性，恢复了下颌骨的骨连续性。术后12周时，松质髂骨移植变成一个硬骨块，其强度与天然下颌骨相当。在重塑的移植骨和钛板之间发现有纤维组织中间层。结果表明，原型移植板可用于修复下颌骨连续性缺损，并可实现满意的美学和功能重建。
