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DOI: 10.1055/s-0033-1350664
Zukünftige Optionen zur Rekonstruktion bei ausgedehnten knöchernen Defekten im Kiefer-, Gesichts- und Schädelbereich mittels CAD/CAM-gefertigter bioaktiver Leitschienen
Future Options for Reconstruction of Extensive Bony Defects in the Craniomaxillofacial Region Using CAD/CAM-Constructed Biological ScaffoldsPublication History
Publication Date:
20 January 2014 (online)
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Zusammenfassung
Großdimensionierte knöcherne Defektsituationen stellen eine beträchtliche Herausforderung für die Mund-, Kiefer- und Gesichtschirurgie dar. Tissue-Engineering-(TE-)Anwendungen haben das Potenzial, in Zukunft eine vielversprechende Alternative zu autologen Regenerationstechniken zu sein. Derzeit gilt bspw. die Verwendung von Kompositscaffolds aus Tricalciumphosphat (TCP) und Polymeren sowie deren Besiedelung mit mesenchymalen Stammzellen oder Fettstammzellen als aussichtsreiche Tissue-Engineering-Strategie. CAD-CAM-Verfahren könnten dabei wesentlich dazu beitragen, die komplexe Morphologie des Gesichtsschädels zu rekonstruieren. Denkbare Indikationen zu Tissue-Engineering-Applikationen bestehen z. B. bei Kontinuitätsdefekten des Unterkiefers, Mittelgesichts- und Kalottendefekten sowie knöchernen Defekten des Kieferspaltbereichs.
Abstract
Large bony defects represent a considerable challenge in craniomaxillofacial surgery. Tissue engineering applications have the ability to serve as an alternative solution to autologous bone transplants. Currently, the use of composite scaffolds made out of TCP or polymers and their subsequent seeding with stem cells can be considered a promising strategy. These stem cells are either derived from bone marrow or adipose tissue. CAD-CAM procedures strongly contribute to reconstruction of the complex craniofacial morphology. Possible indications for TE applications in craniomaxillofacial surgery can be segmental defects of the mandible as well as defects of the mid-face and calvaria.
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