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可生物降解的个体化患者支架在颌面骨再生中的应用:临床研究的范围综述。

Application of biodegradable Patient-specific scaffolds for maxillofacial bone regeneration: a scoping review of clinical studies.

机构信息

Oral and Maxillofacial Surgery Department, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran 1983963113, Iran.

Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Br J Oral Maxillofac Surg. 2023 Nov;61(9):587-597. doi: 10.1016/j.bjoms.2023.08.215. Epub 2023 Sep 7.

Abstract

This study aimed to systematically review clinical studies in which biodegradable patient-specific scaffolds were used for bone regeneration. Studies in which biodegradable scaffolds were fabricated through computer-assisted design and computer-assisted manufacturing (CAD-CAM) procedures were included. Those that applied non-biodegradable materials or used biodegradable materials in a condensable powder or block form were excluded. Among a total of 26 included studies, 11 used customised allogeneic bone blocks, five used polycaprolactone (PCL)-containing scaffolds, four used hydroxyapatite (HA) scaffolds, and four biphasic calcium phosphate (BCP). The majority of the studies applied scaffolds for minor intraoral defects. All the large defects were reconstructed with polymer-containing scaffolds. Results of the included studies showed partial to complete filling of the defect following the application of biodegradable scaffolds. However, limited graft exposure was reported when using PCL, BCP, and HA scaffolds. Tissue engineering can be considered a potential method for the treatment of maxillofacial bone defects. However, more evidence is required, especially for the application of biodegradable scaffolds in large defects.

摘要

本研究旨在系统地回顾使用可生物降解的个体化支架进行骨再生的临床研究。研究中使用了通过计算机辅助设计和计算机辅助制造(CAD-CAM)工艺制造的可生物降解支架。排除了使用不可生物降解材料或使用可生物降解材料的浓缩粉末或块状形式的支架的研究。在总共 26 项纳入的研究中,有 11 项使用了定制的同种异体骨块,5 项使用了含有聚己内酯(PCL)的支架,4 项使用了羟基磷灰石(HA)支架,4 项使用了双相磷酸钙(BCP)。大多数研究将支架应用于小型口腔内缺损。所有大型缺损均使用含聚合物的支架进行重建。纳入研究的结果显示,应用可生物降解支架后,缺损得到了部分至完全填充。然而,当使用 PCL、BCP 和 HA 支架时,报告了有限的移植物暴露。组织工程可以被认为是治疗颌面骨缺损的一种有潜力的方法。然而,需要更多的证据,特别是在大型缺损中应用可生物降解支架的情况。

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