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小儿良性下颌骨肿瘤切除术后同种异体骨移植成功

Successful Grafting with Allogenic Bone Following Benign Pediatric Mandibular Tumor Removal.

作者信息

Somers Sydney, Vitale Alexandra, Dunklebarger Mitchell, Dadzie Aaron, Gociman Barbu

机构信息

From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT.

Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT.

出版信息

Plast Reconstr Surg Glob Open. 2025 Jun 10;13(6):e6830. doi: 10.1097/GOX.0000000000006830. eCollection 2025 Jun.

Abstract

The reconstruction of mandibular defects in pediatric patients presents a significant surgical challenge due to the unique anatomic and developmental considerations of the growing mandible. Advancements in bone tissue engineering have introduced the use of bone graft substitutes and osteoinductive materials such as demineralized bone matrix (DBX), recombinant human bone morphogenetic proteins (BMP), and freeze-dried bone chips (FDBC). Although the current literature using allogenic bone grafts for mandibular defects is limited, existing studies have demonstrated its efficacy in the immediate reconstruction of mandibular defects following benign tumor ablation. In this case series, we evaluate the outcomes of immediate mandibular reconstruction using a combination of DBX, rhBMP-2, and FDBC following 6 benign mandibular tumor removals. At 6 months postoperatively, we achieved no graft failures with 4 (67%) graft sites achieving 100% graft take and 2 (33%) defects achieving approximately 80% graft take. Our results indicate that bone grafting with DBX, BMP, and FDBC could potentially represent a valuable reconstructive technique for pediatric mandibular defects, offering a low-morbid and cost-effective alternative to traditional autologous grafting methods.

摘要

由于生长中的下颌骨具有独特的解剖学和发育方面的考虑因素,小儿患者下颌骨缺损的重建面临重大的手术挑战。骨组织工程学的进展引入了骨移植替代物和骨诱导材料的使用,如脱矿骨基质(DBX)、重组人骨形态发生蛋白(BMP)和冻干骨片(FDBC)。尽管目前使用同种异体骨移植治疗下颌骨缺损的文献有限,但现有研究已证明其在良性肿瘤切除后立即重建下颌骨缺损方面的有效性。在本病例系列中,我们评估了在6例良性下颌骨肿瘤切除术后,联合使用DBX、rhBMP-2和FDBC进行下颌骨即刻重建的效果。术后6个月,我们没有出现移植失败的情况,4个(67%)移植部位实现了100%的移植成功,2个(33%)缺损部位实现了约80%的移植成功。我们的结果表明,使用DBX、BMP和FDBC进行骨移植可能是小儿下颌骨缺损的一种有价值的重建技术,为传统自体移植方法提供了一种低创伤且经济有效的替代方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f59/12150981/d4aabac4be87/gox-13-e6830-g001.jpg

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