Mandibular Bone transport Reconstruction Plate

下颌骨运输重建板

• 批准号: 7118173
• 负责人: LYNNE A. OPPERMAN
• 金额: $ 49.55万
• 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 2010-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7118173
• 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(申请人提供)：手术切除头部和颈部的硬组织和软组织或高冲击性创伤可导致主要组织缺失。下颌骨的重建通常涉及骨骼、牙龈和牙齿。目前的下颌骨牵张器是与重建钢板结合使用的，但当重建钢板获得颌骨的轮廓时，牵张器具有线性向量。这些设备还具有有限的分散距离，会产生较短的直骨片段，因此无法通过一次手术来适应大的缺陷。组合器械的大小使其无法移动齿状骨段。口外器械既是外固定器，又是骨运输牵引器，可以重建下颌骨副关节和下巴。然而，由于软组织压力，新形成的下颌骨后缩，下颌骨无法达到正常的弯曲度。该方案第一阶段的目标是建立和测试一个口腔内下颌牵张装置的原型，在该装置中，重建钢板、推进机构和骨传输装置被组合成一个单一单元。在活体山羊模型中，该原型被建造并被证明是机械坚固的，易于放置和使用，并且能够成功地将齿状骨段跨越2厘米的骨缝。该提案第二阶段的目标是建造和测试该装置的第二代和第三代。这些装置将使齿状骨段能够在包括颌中线在内的大弯曲距离内运输，并防止软组织压力对形态的抑制。这些装置的目的是可以在手术切除后立即重建下颌骨，而不需要植骨或二次重建。该装置的优点是，它们将使我们能够恢复原始下颌骨的机械完整性和形状，并允许在重建的骨中放置种植体时发生适当的咬合。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；传输盘可以安全地携带活牙，而不会在固定过程中损伤牙根。“检查点截骨”技术将使第一次有可能恢复正常的弧度或原来的下颌骨，并保留原来的较低的面部尺寸，因为软组织施加在运输盘上的牵引力被运输钢板刚性遮挡。

项目成果

Biomechanical characteristics of regenerated cortical bone in the canine mandible.

• DOI: 10.1002/term.347
• 发表时间: 2011-07
• 期刊: JOURNAL OF TISSUE ENGINEERING AND REGENERATIVE MEDICINE
• 影响因子: 3.3
• 作者: Zapata, Uriel;Opperman, Lynne A.;Kontogiorgos, Elias;Elsalanty, Mohammed E.;Dechow, Paul C.
• 通讯作者: Dechow, Paul C.

Architecture and microstructure of cortical bone in reconstructed canine mandibles after bone transport distraction osteogenesis.

• DOI: 10.1007/s00223-011-9529-6
• 发表时间: 2011-11
• 期刊: CALCIFIED TISSUE INTERNATIONAL
• 影响因子: 4.2
• 作者: Zapata, Uriel;Halvachs, Emily K.;Dechow, Paul C.;Elsalanty, Mohammed E.;Opperman, Lynne A.
• 通讯作者: Opperman, Lynne A.