3D打印个性化钛网辅助应用于牙槽骨缺损修复的临床观察及组织学分析
Clinical and histological evaluation of three-dimensional printing individualized titanium mesh for alveolar bone defect repair
作者：赵鹏宇, 陈岗, 程熠, 王超, 陈丹, 黄海涛
Author：Zhao Pengyu, Chen Gang, Cheng Yi, Wang Chao, Chen Dan, Huang Haitao
收稿日期：2024-12-31 年卷（期）页码：2025,43(4):592-592-602
期刊名称：华西口腔医学杂志
Journal Name：West China Journal of Stomatology
关键字：3D打印个性化钛网,引导骨再生,组织学,组织计量学,钛网暴露,
Key words：three-dimensional printing individualized titanium mesh,guided bone regeneration,histology,histomorphometry,titanium mesh exposure,
基金项目：国家自然科学基金(12472301);辽宁省医工联合创新基金(DMU-1&DICPUN202210);北京市自然科学基金(L2120-63)
中文摘要
目的 评估3D打印个性化钛网（3D-PITM）作为支架材料在引导骨再生术（GBR）中的成骨效能。 方法 1）选取因牙槽骨缺损接受GBR治疗的患者作为研究对象，记录术后愈合并发症发生情况；2）获取术后至少6个月的颌骨锥形束计算机断层扫描（CBCT）影像数据，计算实际成骨体积百分比；3）在种植一期手术同期收集牙槽骨标本进行组织计量学分析，定量检测标本内新生骨及新生未矿化骨占比。同时，根据愈合并发症将标本分为3组（创口愈合良好组、创口裂开组、3D-PITM暴露组），比较各组间新生骨及新生未矿化骨比例的差异。 结果 1）本研究共纳入12例患者。其中1例GBR手术失败，3例发生3D-PITM暴露（暴露率25%）。2）11例GBR手术成功患者的实际成骨体积百分比为95.23%±28.85%。3）组织计量学分析显示，牙槽骨标本中新生骨占比40.35%，其中新生未矿化骨占新生骨的13.84%。组间比较显示：创口愈合良好组的新生骨及新生未矿化骨占比与创口裂开组及3D-PITM暴露组相比，差异无统计学意义（P>0.05）。 结论 3D-PITM影像学评估显示成骨体积良好，组织学分析证实术区有大量新生矿化骨形成，可实现理想的骨增量效果。
英文摘要
ObjectiveTo evaluate the osteogenic efficacy of three-dimensional printing individualized titanium mesh (3D-PITM) as a scaffold material in guided bone regeneration (GBR).Methods1) Patients undergoing GBR for alveolar bone defects were enrolled as study subjects, and postoperative healing complications were recorded. 2) Postoperative cone beam computed tomography (CBCT) scans acquired at least 6 months post-surgery were used to calculate the percentage of actual bone formation volume. 3) Alveolar bone specimens were collected during the first-stage implant surgery for histomorphometric analysis. This analysis quantitatively measured the proportions of newly formed bone and newly formed unmineralized bone within the specimens. Specimens were categorized into three groups based on healing complications (good healing group, wound dehiscence group, 3D-PITM exposure group) to compare differences in the proportions of newly formed bone and newly formed unmineralized bone.Results1) Twelve patients were included. Guided bone regeneration failed in one patient, and 3D-PITM exposure occurred in three patients (exposure rate: 25%). 2) The mean percentage of actual bone formation volume in the 11 successful guided bone regeneration cases was 95.23%±28.85%. 3) Histomorphometric analysis revealed that newly formed bone constituted 40.35% of the alveolar bone specimens, with newly formed unmineralized bone accounting for 13.84% of the newly formed bone. Intergroup comparisons showed no statistically significant differences (P>0.05) in the proportions of newly formed bone or newly formed unmineralized bone between the good healing group and the wound dehiscence group or the 3D-PITM exposure group.Conclusion3D-PITM enables effective bone augmentation. Radiographic assessment demonstrated favorable bone formation volume, while histological analysis confirmed substantial formation of newly formed mineralized bone within the surgical site.
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