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一种用于颌面骨重建的创新型 3D 羟基磷灰石个体化植入物:13 例病例系列。

An innovative 3D hydroxyapatite patient-specific implant for maxillofacial bone reconstruction: A case series of 13 patients.

机构信息

Department of Plastic and Maxillofacial Surgery, CHU, University of Liège, Liège, Belgium; Department of Oral and Maxillofacial Surgery, ZOL Genk, Genk, Belgium.

CERHUM SA, Liège, Belgium.

出版信息

J Craniomaxillofac Surg. 2024 Apr;52(4):420-431. doi: 10.1016/j.jcms.2024.02.026. Epub 2024 Feb 28.

Abstract

The study aimed to evaluate and discuss the use of an innovative PSI made of porous hydroxyapatite, with interconnected porosity promoting osteointegration, called MyBone Custom® implant (MBCI), for maxillofacial bone reconstruction. A multicentric cohort of 13 patients underwent maxillofacial bone reconstruction surgery using MBCIs for various applications, from genioplasty to orbital floor reconstruction, including zygomatic and mandibular bone reconstruction, both for segmental defects and bone augmentation. The mean follow-up period was 9 months (1-22 months). No infections, displacements, or postoperative fractures were reported. Perioperative modifications of the MBCIs were possible when necessary. Additionally, surgeons reported significant time saved during surgery. For patients with postoperative CT scans, osteointegration signs were visible at the 6-month postoperative follow-up control, and continuous osteointegration was observed after 1 year. The advantages and disadvantages compared with current techniques used are discussed. MBCIs offer new bone reconstruction possibilities with long-term perspectives, while precluding the drawbacks of titanium and PEEK. The low level of postoperative complications associated with the high osteointegration potential of MBCIs paves the way to more extensive use of this new hydroxyapatite PSI in maxillofacial bone reconstruction.

摘要

本研究旨在评估和讨论一种新型多孔羟基磷灰石 PSI 的应用,该 PSI 具有促进骨整合的互连通孔结构,称为 MyBone Custom®植入物(MBCI),用于颌面骨重建。一个多中心队列的 13 名患者接受了使用 MBCI 进行的颌面骨重建手术,这些患者的应用包括颏成形术、眶底重建术,包括颧骨和下颌骨重建术,既有节段性缺损,也有骨增量。平均随访期为 9 个月(1-22 个月)。无感染、移位或术后骨折报告。必要时可对 MBCI 进行围手术期修改。此外,外科医生报告说手术期间节省了大量时间。对于有术后 CT 扫描的患者,术后 6 个月的随访控制可见骨整合迹象,且在 1 年后观察到持续的骨整合。讨论了与当前使用的技术相比的优缺点。MBCI 提供了具有长期前景的新的骨重建可能性,同时避免了钛和 PEEK 的缺点。MBCI 术后并发症发生率低,且具有较高的骨整合潜力,为这种新型羟基磷灰石 PSI 在颌面骨重建中的更广泛应用铺平了道路。

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