Weiss Robert O, Wong Patrick E, Reddy Likith V
Department of Oral and Maxillofacial Surgery, Baylor University Medical Center and Texas A&M College of Dentistry, Dallas, Texas.
Proc (Bayl Univ Med Cent). 2022 Mar 3;35(3):391-393. doi: 10.1080/08998280.2022.2035162. eCollection 2022.
Ameloblastomas are benign, locally invasive odontogenic tumors that comprise approximately 1% of tumors within the jaws, with 66% located in the posterior mandible. If left untreated, these lesions can reach enormous size, resulting in considerable deformity and associated morbidity. Traditionally, defects >6 cm warranted a free-flap fibula transfer or iliac crest autogenous graft. Surgical treatment for the two presented cases included a large (>6 cm) mandibular segmental resection with immediate reconstruction via a tissue-engineering protocol that included bone morphogenetic protein (rhBMP-2), bone marrow aspirate concentrate, and cortical bone chips. Both patients had an uneventful postoperative course and healed satisfactorily. Established bone reconstruction determinants include bone volume, facial counter, esthetics, and restoration of functionality. Advances in tissue engineering provide a legitimate alternative while decreasing the risks, length of hospital stay, and postoperative morbidity.
成釉细胞瘤是一种良性、具有局部侵袭性的牙源性肿瘤，约占颌骨肿瘤的1%，其中66%位于下颌骨后部。如果不进行治疗，这些病变可能会长得很大，导致严重的畸形和相关的发病率。传统上，缺损>6 cm需要进行游离腓骨瓣转移或自体髂嵴移植。这两例病例的手术治疗包括大块（>6 cm）下颌骨节段性切除，并通过组织工程方案立即重建，该方案包括骨形态发生蛋白（rhBMP-2）、骨髓抽吸浓缩物和皮质骨碎片。两名患者术后过程顺利，愈合良好。既定的骨重建决定因素包括骨体积、面部外形、美学和功能恢复。组织工程的进展提供了一种合理的替代方案，同时降低了风险、缩短了住院时间并减少了术后发病率。
