Abstract:
Mandibular continuity defects are commonly seen after tumor resection, osteomyelitis or maxillofacial trauma. Three-dimensional reconstruction of these mandibular segmental defects is critical for proper mandibular functioning and esthetics. Various methods used to reconstruct such defects include bridging reconstruction plates, modular endoprosthesis, non-vascularized and vascularized bone grafting with stock reconstruction plate or patient specific implants (PSI) and tissue engineering bone transfer. But in the recent years, literature documents use of PSI only alloplastic reconstruction as an alternate to microvascular bone flap reconstruction. Representative cases enumerate current practice of \'patient specific implant only\' mandibular reconstruction and its pitfalls. This article discusses current status of literature on PSI\'s, choice of indications for \'PSI only\' mandibular reconstruction and also proposes guidelines for safe practice of patient specific implant reconstruction of mandible.
摘要:
下颌骨连续性缺损常见于肿瘤切除后,骨髓炎或颌面部创伤。这些下颌节段性缺陷的三维重建对于正确的下颌功能和美学至关重要。用于重建此类缺陷的各种方法包括桥接重建板,模块化内置假体,非血管化和血管化的骨移植与原始重建板或患者特异性植入物(PSI)和组织工程骨转移。但近年来,文献文献仅使用PSI同种异体重建作为微血管骨瓣重建的替代方法。代表性案例列举了“仅患者特定植入物”下颌骨重建的当前实践及其陷阱。本文讨论了PSI的文献现状,选择“仅PSI”下颌骨重建的适应症,并提出了针对患者特定的下颌骨种植重建的安全实践指南。