Mandibular Bone transport Reconstruction Plate

下颌骨运输重建板

• 批准号: 6935061
• 负责人: LYNNE A. OPPERMAN
• 金额: $ 49.61万
• 依托单位: CUSTOM SCIENTIFIC
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-08-06 至 2007-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6935061
• 关键词: Macaca mulatta; biomaterial development /preparation; biomechanics; bone regeneration; clinical research; endosseous dental implant; goats; human tissue; mandible /maxilla; medical implant science; oral facial restoration; osteogenesis; postmortem; ribs; titanium

DESCRIPTION (provided by applicant): Surgical excision of hard and soft tissues of the head and neck or high impact trauma can lead to lead to major tissue deficits. Reconstruction of the lower jaw typically involves bone, gingiva, and teeth. Current mandibular distraction devices are used in combination with reconstruction plates, but while the reconstruction plates take the contour of the jaw, the distraction devices have a linear vector. The devices also have a limited distraction distance, producing short segments of straight bone and so cannot accommodate large deficits with a single procedure. The size of the combined apparatus makes it impossible to move dentate bone segments. Extra-oral devices function both as external fixator and bone-transport distraction devices, with which it is possible to re-build the mandibular parasymphysis and chin. However, the newly formed mandible is retruded due to soft tissue pressure and normal curvature of the mandible is not achieved. The objective of Phase I of this proposal was to build and test a prototype of an intra-oral mandibular distraction device in which the reconstruction plate, advancing mechanism and bone transport device are combined into a single unit. The prototype was built and shown to be mechanically robust, easy to place and use, and able to successfully transport a dentate bone segment across a 2cm bony gap in a live goat model. The objective of Phase II of this proposal is to build and test the second and third generations of this device. These devices will enable transport of dentate bone segments over large curved distances including the midline of the jaw, and prevent the inhibition of form by soft tissue pressure. The purpose of these devices is to allow immediate reconstruction of mandibular bone following surgical excision, eliminating the need for bone grafting or secondary reconstruction. The advantage of the devices is that they will enable us to regain the mechanical integrity and shape of the original mandible, and allow appropriate occlusion to occur when implants are placed in the reconstructed bone. This will be done without adding to the difficulty, duration, or complication of surgeries. A critical feature of the devices is that they are not limited by the size, shape, or location of the bone gap and because of the low position of the device; the transport disc can safely carry viable teeth without injuring the roots during fixation. The "check-point osteotomy" technique will make it possible for the first time to regain the normal curvature or the original mandible, and preserve the original lower facial dimensions as the traction force exerted by the soft tissue over the transport disc is rigidly shielded by the transport plate.

描述（由申请人提供）：头颈部硬组织和软组织的手术切除或高冲击性创伤可能导致重大组织缺损。下颌骨的重建通常涉及骨骼，牙龈和牙齿。当前的下颌骨牵引装置与重建板组合使用，但是当重建板采用颌的轮廓时，牵引装置具有线性矢量。这些器械的牵引距离也有限，产生的直骨节段较短，因此无法通过一次手术适应较大的缺损。组合装置的尺寸使得不可能移动齿状骨段。口外器械既可作为外固定支架，又可作为骨转移牵引器械，可以重建下颌副交感和颏部。然而，新形成的下颌骨由于软组织压力而后退，并且下颌骨的正常曲率未实现。本提案第一阶段的目标是构建和测试口腔内下颌骨牵引装置的原型，其中重建板、推进机制和骨输送装置组合成一个单元。该原型被构建并被证明是机械坚固的，易于放置和使用，并且能够在活山羊模型中成功地将齿状骨段运送穿过2cm的骨间隙。本提案第二阶段的目标是构建和测试该器械的第二代和第三代。这些器械将能够在包括颌骨中线在内的较大弯曲距离上输送齿状骨段，并防止软组织压力对形状的抑制。这些器械的目的是在手术切除后立即重建下颌骨，无需植骨或二次重建。这些装置的优点是，它们将使我们能够恢复原始下颌骨的机械完整性和形状，并允许在将种植体放置在重建骨中时发生适当的咬合。这将在不增加手术难度、持续时间或并发症的情况下完成。该装置的一个关键特征是，它们不受骨间隙的大小、形状或位置的限制，并且由于装置的位置较低;运输盘可以安全地携带活齿，而不会在固定过程中损伤牙根。“检查点截骨术”技术将首次使恢复正常曲率或原始下颌骨成为可能，并保留原始下面部尺寸，因为软组织施加在运输盘上的牵引力被运输板刚性屏蔽。