骨缺损修复生物材料与骨再生

摘要

大范围颌骨缺损是临床上亟待解决的难题,随着生物材料、干细胞及骨组织工程技术的发展,为颌骨再生提供了新的思路和希望.用于大块颌骨再生的支架除需满足骨修复材料的基本要求外,还需要具有调控干细胞参与骨再生的能力.支架材料的成分优化、孔隙结构设计、结合凝胶及微球体使用等方法能增加干细胞的体内投递量;通过药物缓控释、微纳米结构和离子成分改性,可以促进干细胞的成骨分化;三维打印技术和管道设计等方法在大支架制备中的应用有助于解决个性化精确修复及血管化的问题.只有通过各方面的协同优化,才有望获得适用大块颌骨再生的生物支架材料.本文重点从生物材料调控干细胞的投递、存活和分化及其在骨再生中的作用等角度进行阐述.%The treatment of large jaw bone defects remains an urgent clinical problem to be solved. With the development of biomaterials, stem cells and bone tissue engineering, new ideas and hopes for the regeneration of jaw have been offered. In addition to meeting the basic requirements of bone repair materials, scaffolds for the regeneration of large jaw bones require the ability of stem cells to participate in bone regeneration. Methods like optimization of scaffolds composition, design of porous structure and combination of gel and microsphere technology can enhance stem cell delivery in vivo, and the osteogenic differentiation of stem cells can be stimulated through controlled release of drugs, preparation of surface micronano topography and modifications of ionic components. Moreover, application of three-dimensional printing and channel structure in large-scale scaffolds fabrication present promising strategies for customized, accurate bone reconstruction and vascularization. It is only through synergistic optimization in all aspects that it is possible to obtain scaffold materials suitable for regeneration of large jaw bones. This article focuses on biological materials regulation, stem cell delivery, survival and differentiation, and their role in bone regeneration.