Synthetic osteo-odonto-keratoprosthesis (OOKP, Tooth-in-Eye surgery)

合成骨齿角膜假体（OOKP，牙眼手术）

• 批准号: 10722533
• 负责人: Lobat Tayebi
• 金额: $ 42.49万
• 依托单位: MARQUETTE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-30 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10722533
• 关键词: 3D Print; Accountability; Adhesions; Alloys; Area; Artificial Implants; Autologous; Autologous Transplantation; Biocompatible Materials; Biological; Biomedical Engineering; Bullous Pemphigoid; Cells; Characteristics; Chemical Burns; Child; Coculture Techniques; Collaborations; Complex; Consumption; Cornea; Corneal Diseases; Corneal Injury; Dental; Dentin; Dentition; Dimensions; Endothelial Cells; Eye; Failure; Fibroblasts; Funding; Future; Growth; Harvest; Human; Implant; In Vitro; Infiltration; Injury; Keratoplasty; Legal patent; Length; Measures; Mechanics; Methods; Modulus; Morphology; Ocular cicatricial pemphigoid; Operative Surgical Procedures; Ophthalmologic Surgical Procedures; Ophthalmology; Optics; Oral cavity; Patients; Pattern; Penetrating Keratoplasty; Polymethyl Methacrylate; Porosity; Procedures; Proliferating; Property; Prosthesis; Recording of previous events; Sampling; Scientist; Solid; Stevens-Johnson Syndrome; Structure; Surgeon; Techniques; Time; Tissue Harvesting; Tissues; Titanium; Tooth structure; Trachoma; Umbilical vein; United States National Institutes of Health; Vascularization; alveolar bone; bone; density; design; effective therapy; experimental study; graft failure; in vitro Assay; in vivo; migration; multidisciplinary; novel; permanent tooth; severe injury; sight restoration; success

Project Summary: Osteo-odonto-keratoprosthesis (OOKP) or Tooth-in-Eye surgery is an exceptional procedure that can save severely injured corneas. The OOKP procedure is effective and capable of treating corneas after multiple corneal transplantation failures, or when the cornea is severely damaged by Stevens–Johnson syndrome, pemphigoid, chemical burns, trachoma and multiple corneal graft failure. The success rate in OOKP is high, however, it is an aggressive procedure, time consuming and involves partial sacrifice of the patient's oral cavity. This proposal aims to simplify this surgery by making a novel OOKP synthetic prosthesis. At the first stage of the OOKP surgery, a patient's tooth and surrounding tissue are harvested to make an autograft prosthesis called an osteo-odonto-lamina into which an optical cylinder is placed. This construct is then implanted into a submuscular pouch for 2–4 months to be vascularized. At the second stage of the surgery, the vascularized osteo-odonto-lamina is inserted into the eye to act as a frame for holding a PMMA optical cylinder. In this proposal, we build a special keratoprosthesis for the OOKP surgery as a replacement of the osteo-odonto- lamina so the surgeons do not need to harvest teeth and surrounding jawbone of the patients. For this purpose, we will follow the general design we have proposed in our recently issued patent. Although the design and idea of the keratoprosthesis have already been proposed in our patent, it has not been produced, and the details of the construct are yet to be configured in this proposal. More specifically, we are going to figure out the material, density, porosity, and pore-size of the different parts of the prosthesis in a way to mimic the details of the natural osteo-odonto-lamina structure, and particularly mimic the features of it that are accountable for the success of OOKP surgery. We will use a titanium alloy and 3D-printing technique to fabricate this keratoprosthesis. By considering our criteria for mimicking such construct, we will make 18 samples. They will go through a full physical, mechanical, and in vitro characterizations to find the most optimized synthetic OOKP keratoprosthesis. In sum, OOKP surgery is a multi-disciplinary, labor-intensive, and invasive procedure requiring both dental and ophthalmology expertise. Through the use of our new prothesis, the OOKP procedure can eliminate one very aggressive stage of the surgery that harms patients and can reduce the overall length of the treatment by a few months. It will considerably enhance the treatment of patients with severely injured corneas.

项目总结： 骨-牙-角膜假体(OOKP)或眼中牙手术是一种特殊的手术，可以节省 眼角膜严重受伤。OOKP手术是治疗多发性角膜术后角膜的有效方法 移植失败，或当角膜因史蒂文斯-约翰逊综合征，类天疱疮， 化学烧伤、沙眼和多发性角膜移植失败。 OOKP的成功率很高，但它是一个激进的过程，耗时长，涉及部分 牺牲病人的口腔。这项提议旨在通过使一种新型的OOKP合成来简化手术 假肢。 在OOKP手术的第一阶段，患者的牙齿和周围组织被采集来制造 自体移植假体被称为骨齿状椎板，在其中放置一个光柱。 然后将这种结构植入肌下袋中，持续2-4个月，进行血管化。在第二个 在手术阶段，带血管的骨牙本质板被插入眼睛，作为支撑的框架。 一个PMMA光学圆柱体。 在这项建议中，我们为OOKP手术建造了一种特殊的角膜假体，作为骨牙本质的替代品- 因此，外科医生不需要采集患者的牙齿和周围的颌骨。 为此，我们将遵循我们在最近发布的专利中提出的一般设计。尽管 假体的设计和构思已经在我们的专利中提出了，还没有生产出来， 而建造的细节还有待于在这份提案中配置。更具体地说，我们将计算出 找出假体不同部分的材料、密度、孔隙率和孔大小，以模仿 自然骨-牙本质-椎板结构的细节，特别是模仿它的特征 为OOKP手术的成功。我们将使用钛合金和3D打印技术来制造这个 角膜假体。 通过考虑我们模仿这种结构的标准，我们将制作18个样本。他们将经历一个完整的 物理、机械和体外特性，以寻找最优化的合成OOKP角膜假体。 总之，OOKP手术是一种多学科的、劳动密集型和侵入性的手术，需要牙科和 眼科专业知识。通过使用我们的新假体，OOKP程序可以消除一个非常 手术的攻击性阶段，对患者造成伤害，并可将治疗的总长度减少几个 月份。它将极大地提高严重角膜损伤患者的治疗水平。