Dolgolev Alexander, Reshetov Igor, Svyatoslavov Dmitry, Sinelnikov Mikhail, Kudrin Konstantin, Dub Vladimir, Put Vladimir, Anikin Vladimir
Department of General and Pediatric Dentistry, Stavropol State Medical University, 310 Mira str., Stavropol 355017, Russia.
Department of Oncology and Reconstructive Surgery, Sechenov University, Ministry of Health of Russia, Bolshaya Pirogovskaya, 6/1, Moscow 119431, Russia.
J Pers Med. 2020 Feb 3;10(1):6. doi: 10.3390/jpm10010006.
: Mandibular reconstruction, after extensive resection of the mandible for the treatment of oral cancer, is a well-known procedure, however, relatively little is known about bone integration into the titanium implant after reconstruction with a temporary plastic implant. The main goal of this experimental study was to study the process of osseous integration into the titanium implant in an in vivo experiment following prior mandibular reconstruction with a temporary plastic implant. : Four ewes initially underwent a partial one-sided resection of the mandible, with the formation of an approximately 3 × 1 cm defect. All of the subjects received reconstruction with an implantation of a plastic plate (3 cm). The plastic plate was removed and replaced by a titanium implant at 1, 3, 6, and 12 months, accordingly. Both plastic and titanium implants were made via 3D-printing technology and personalized modeling. A total of 6 months after titanium implantation, a histological evaluation of biointegration was performed. : All surgeries were uncomplicated. The integration of osseous tissue into the titanium implant was seen in all cases. Histologically, each case showed variable integration of dense fibrotic tissue with fibroblasts and non-mature bone tissue with a definitive layer of bone matrix with many osteoblasts on the periphery. The prior implantation of the plastic plate did not interfere with bone integration into the titanium implant. : Preliminary results demonstrated that a temporary plastic implant for mandibular reconstruction does not interfere with the consequent osseous biointegration of a permanent titanium implant. This shows that temporary reconstruction is a safe solution when delayed mandibular reconstruction is required due to disease severity.
对于因治疗口腔癌而广泛切除下颌骨后的下颌骨重建，这是一种广为人知的手术，然而，在用临时塑料植入物重建后，关于骨与钛植入物的整合情况相对知之甚少。本实验研究的主要目的是在先前用临时塑料植入物进行下颌骨重建后的体内实验中，研究骨与钛植入物的整合过程。
四只母羊最初接受了下颌骨的部分单侧切除，形成了一个约3×1厘米的缺损。所有受试者均接受了塑料板（3厘米）植入的重建。塑料板在1、3、6和12个月时分别被取出并替换为钛植入物。塑料和钛植入物均通过3D打印技术和个性化建模制作。钛植入6个月后，进行了生物整合的组织学评估。
所有手术均无并发症。在所有病例中均可见骨组织与钛植入物的整合。组织学上，每个病例均显示致密纤维组织与成纤维细胞以及未成熟骨组织的不同程度整合，并有一层明确的骨基质，其周边有许多成骨细胞。先前植入的塑料板并未干扰骨与钛植入物的整合。
初步结果表明，用于下颌骨重建的临时塑料植入物不会干扰后续永久钛植入物的骨生物整合。这表明，当由于疾病严重程度需要延迟下颌骨重建时，临时重建是一种安全的解决方案。
