口腔疾病防治 ›› 2021, Vol. 29 ›› Issue (10): 711-715.DOI: 10.12016/j.issn.2096-1456.2021.10.011

• 综述 • 上一篇    下一篇

青少年下颌骨缺损修复重建的研究进展

宾志文1(),王方2,侯劲松2()   

  1. 1.广西桂林市第二人民医院口腔科,广西壮族自治区 桂林(541001)
    2.中山大学光华口腔医学院·附属口腔医院口腔颌面外科,广东 广州(510055)
  • 收稿日期:2021-02-23 修回日期:2021-04-20 出版日期:2021-10-20 发布日期:2021-06-23
  • 通讯作者: 侯劲松
  • 作者简介:宾志文,副教授,硕士,Emal: bzw2703@126.com
  • 基金资助:
    国家自然科学基金项目(81874128)

Research progress on the reconstruction of mandibular defects in adolescents

BIN Zhiwen1(),WANG Fang2,HOU Jinsong2()   

  1. 1. Department of Stomatology, Guilin Second People’s Hospital, Gunlin 541001, China
    2. Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou 510055, China
  • Received:2021-02-23 Revised:2021-04-20 Online:2021-10-20 Published:2021-06-23
  • Contact: Jinsong HOU
  • Supported by:
    National Natural Science Foundation of China(81874128)

摘要:

青少年下颌骨缺损多由良恶性肿瘤手术切除、创伤和颌骨炎症所致,其修复重建具有一定挑战性,除了成人颌骨重建面临的问题外,手术对供区和受区生长发育的影响、缺损重建的远期疗效以及移植骨的转归效果也是必须考虑的临床因素。目前重建主要方法包括自体骨移植和牵张成骨。从远期效果看,自体骨移植依然是治疗的金标准。青少年腓骨瓣修复下颌骨病例在术后表现出良好的生长潜力;肋软骨修复髁状突病例恢复了正常咬合关系并具有长期稳定效果。牵张成骨的安全性和临床效果也值得肯定,但是下颌骨大范围缺损病例长期效果尚不确切。此外,其他组织工程技术对于青少年颌骨缺损的修复重建也具有良好的应用前景,但有待于更深入的基础研究和更广泛的临床试验去验证其疗效。

关键词: 青少年, 下颌骨缺损, 下颌骨重建, 口腔颌面, 血管化游离组织瓣, 骨移植, 牵张成骨, 骨组织工程

Abstract:

Mandibular defects in adolescents are mostly caused by surgical resection of benign and malignant tumors, trauma and jaw inflammation. The reconstruction of mandibular defects in adolescents is challenging. In addition to solving the problem of jaw reconstruction in adults, some clinical factors, including the influence of surgery on the growth of donor and recipient areas, the long-term effects of reconstruction, and the outcome of bone grafts, must also be considered. At present, the main reconstructive methods include autogenous bone grafts and distraction osteogenesis. Autogenous bone grafts are still the gold standard due to their long-term effects. Favorable growth potential after repair was shown in adolescent cases of mandibular reconstruction with fibula flap. Normal occlusion was restored, and a long-term stable effect was achieved in cases of condylar reconstruction with costal cartilage. The safety and clinical effects of distraction osteogenesis have been confirmed, but the long-term effects of large-scale mandibular defects are still uncertain. In addition, other tissue engineering techniques also have good application prospects for the repair and reconstruction of adolescent mandible defects, but more in-depth basic research and more extensive clinical trials should be performed to verify the efficacy.

Key words: adolescent, mandibular defect, mandibular reconstruction, oral and maxillofacial, vascularized free tissue flap, bone graft, distraction osteogenesis, bone tissue engineering

中图分类号: