CAJ | 학술논문

背景：预制个性化骨瓣具有创伤小、血运好、可带软组织、形状可定制等优点，可用来修复血管床欠佳的骨缺损。 　　目的：建立预制骨瓣修复灵长类下颌骨缺损的动物模型。 　　方法：对9只恒河猴进行头颅扫描并制作个性化钛网。将复合或者未复合人重组骨形态发生蛋白2的脱钙冻干骨、珊瑚装入个性化钛网，植入背阔肌中进行个性化、血管化组织工程骨瓣的预制或者原位植入下颌骨节段性缺损。13周时，个性化、血管化组织工程骨瓣预制成功，将其转移修复下颌骨节段型缺损。采用临床和组织学方法观察异位预制个性化骨瓣及原位植入人重组骨形态发生蛋白2修复下颌骨缺损的效果。 　　结果与结论：预制骨瓣和原位植入的复合人重组骨形态发生蛋白2的珊瑚能修复下颌骨节段性缺损；原位植入复合或未复合人重组骨形态发生蛋白2的脱钙冻干骨和单纯珊瑚不能修复下颌骨缺损。复合人重组骨形态发生蛋白2的脱钙冻干骨、珊瑚预制个性化、血管化组织工程骨瓣成功，转移后均能成功修复下颌骨缺损，而且修复下颌骨缺损的效果优于材料直接植入下颌骨缺损组。实验证实预制个性化骨瓣修复恒河猴下颌骨缺损模型是可行的。
배경：예제개성화골판구유창상소、혈운호、가대연조직、형상가정제등우점，가용래수복혈관상흠가적골결손。 　　목적：건립예제골판수복령장류하합골결손적동물모형。 　　방법：대9지항하후진행두로소묘병제작개성화태망。장복합혹자미복합인중조골형태발생단백2적탈개동간골、산호장입개성화태망，식입배활기중진행개성화、혈관화조직공정골판적예제혹자원위식입하합골절단성결손。13주시，개성화、혈관화조직공정골판예제성공，장기전이수복하합골절단형결손。채용림상화조직학방법관찰이위예제개성화골판급원위식입인중조골형태발생단백2수복하합골결손적효과。 　　결과여결론：예제골판화원위식입적복합인중조골형태발생단백2적산호능수복하합골절단성결손；원위식입복합혹미복합인중조골형태발생단백2적탈개동간골화단순산호불능수복하합골결손。복합인중조골형태발생단백2적탈개동간골、산호예제개성화、혈관화조직공정골판성공，전이후균능성공수복하합골결손，이차수복하합골결손적효과우우재료직접식입하합골결손조。실험증실예제개성화골판수복항하후하합골결손모형시가행적。
BACKGROUND:Prefabricated customized bone flaps have the advantages of few trauma, good vascularization, ossification with predetermined shape, and can be used to restore bone defects with compromised blood bed. OBJECTIVE:To establish animal models of mandibular reconstruction with prefabricated, customized bone flaps. METHODS:After computed tomography scanning of nine rhesus’ head, customized meshes were made. After loading with recombinant human bone morphogenetic protein-2-incorporated demineralized freeze-dried bone al ograft (DFDBA) or coral ine hydroxyapatite (CHA), the constructs were implanted in latissimus dorsi muscle. Meanwhile, segmental mandibular defects were created, and the customized meshes loaded with DFDBA, CHA, or recombinant human bone morphogenetic protein-2-incooperated DFDBA and CHA were implanted in situ. At 13 weeks, prefabricated bone flaps with recombinant human bone morphogenetic protein-2-incorporated DFDBA or CHA were transferred to repair segmental mandibular defects. Clinical and histological analyses were used to evaluate the ossification and vascularization of the prefabricated implants in ectopic and orthotopic sites. RESULTS AND CONCLUSION:Segmental mandibular defects were successful y restored with prefabricated bone flaps and recombinant human bone morphogenetic protein-2-incorporated CHA in situ, but other segmental mandibular defects remained with recombinant human bone morphogenetic protein-2-incorporated DFDBA, DFDBA and CHA in situ. Moreover, mandibles reconstructed with prefabricated bone flaps revealed more regenerated and homogeneous bone formation than other reconstructions. These findings suggest that the animal model of mandibular reconstruction with prefabricated, customized bone in rhesus monkey is applicable.