Schendel S, Bresnick S, Cholon A
Department of Functional Restoration, Stanford University Medical Center, CA 94305, USA.
Ann Plast Surg. 1997 Feb;38(2):158-62.
Simple ceramic bone graft materials have demonstrated significant limitations for use in craniomaxillary reconstruction. We investigated a new, alloplastic composite bone grafting material containing particulate hydroxyapatite and crosslinked collagen in a time-sequence study. Five rabbits underwent surgical placement of high-loading and low-loading composite onlay and inlay grafts in the parietal region of the skull. Animals were sacrificed at either 1, 2, 4, or 6 months postoperatively. All rabbits demonstrated tissue continuity and healing of both onlay and inlay grafts to the outer table of the skull. Bony ingrowth was shown in both onlays and inlays with bone proliferation and vascularization. Bony ingrowth was seen as early as 1 month postoperatively. Inlay grafts healed flush to the outer table, while onlay grafts maintained at least 80% of graft volume at 6 months postoperatively. We conclude that a composite bone grafting material containing a ceramic and collagenous matrix may offer significant advantages to the reconstructive surgeon. The material appears to be easy to handle and carve, is biologically tolerated, and is able to maintain graft volume. Further studies of this new composite material are warranted.
简单的陶瓷骨移植材料在颅颌面重建中的应用已显示出显著局限性。我们在一项时间序列研究中，对一种含有颗粒状羟基磷灰石和交联胶原蛋白的新型异体复合骨移植材料进行了研究。五只兔子在颅骨顶区接受了高负荷和低负荷复合贴附式和嵌入式移植手术。术后1、2、4或6个月处死动物。所有兔子均显示贴附式和嵌入式移植均与颅骨外板实现了组织连续性和愈合。贴附式和嵌入式移植均出现骨向内生长，伴有骨增殖和血管化。术后1个月就可见骨向内生长。嵌入式移植与外板愈合平整，而贴附式移植在术后6个月时至少维持了80%的移植体积。我们得出结论，一种含有陶瓷和胶原基质的复合骨移植材料可能为重建外科医生带来显著优势。该材料似乎易于操作和雕刻，具有生物耐受性，并且能够维持移植体积。有必要对这种新型复合材料进行进一步研究。
