骨放射坏死（ORN）是放射治疗的重要并发症，是一种非感染性坏死骨病。目前其常规处理方式主要包括对患病骨进行冲洗或完全切除。骨组织工程（OTE）是一种新的策略，通过使用生物相容性支架和微分子以及再生骨细胞来重建骨组织。本研究纳入了放疗导致的口咽部鳞癌后下颌骨ORN的病例。将自体培养扩增的牙髓干细胞（DPSCs）与自体未培养的骨髓抽吸浓缩液（BMAC）和自体富血小板血浆（PRP）混合负载于β—磷酸三钙（β—TCP）或羟基磷灰石（HA）海绵支架中，用于下颌骨缺损和周围组织的重建。检测了患者的临床、影像和功能属性。共纳入6例患者，平均年龄为58.6岁。获得了术后疼痛评分和口张开度的显著改善；进食固体/液体食物、舌头活动、言语和吞咽功能的改善；外观得分采用温哥华评分进行测量，P < 0.05，显示具有统计学意义；所有患者均有唇任两次和咬合。经过平均28个月的随访，未发现重大并发症。利用自体培养扩增的DPSCs、自体未培养的BMAC和自体PRP负载于HA或β-TCP，在下颌骨手术重建中进行组织工程治疗是治疗放射性下颌骨ORN的有效方法。 版权：© 2023年《颌面外科年鉴》。

Osteoradionecrosis (ORN), a non-infectious, necrotic condition of the bone, occurs as a major complication of radiotherapy to the irradiated site. Simple irrigation of the involved bone to partial or complete resection of the involved bones is being employed in its conventional management. Osseous tissue engineering (OTE) provides a new strategy by regenerating bone cells along with biocompatible scaffolds and micromolecules to produce an engineered osseous tissue.In this study, mandibular ORN following radiation secondary to oropharyngeal squamous cell carcinoma was included. OTE with composite engineered tissue containing a mixture of autologous culture expanded dental pulp stem cells (DPSCs), autologous uncultured bone marrow aspiration concentrate (BMAC) and autologous platelet-rich plasma (PRP) loaded in β-tricalcium phosphate (β-TCP) or hydroxyapatite (HA) sponge scaffold was used in the mandibular defect and the surrounding tissues. An assessment of clinical, radiological and functional attributes was done.A total of six cases with a mean age of 58.6 years were included in the study. We noted significant improvement in the mean post-operative score for pain and mouth opening; functional improvement in eating solid/liquid food, tongue movement, speech and deglutition were observed. The aesthetics was measured with Vancouver score and revealed a significance at P < 0.05; also lip competency and occlusion were noted in all the patients. No major complications were noticed until a mean follow-up of 28 months.Tissue engineering with a regenerative cocktail of autologous culture expanded DPSCs, autologous uncultured BMAC and autologous PRP loaded in HA or β-TCP utilised in the surgical reconstruction of the mandible is an effective treatment modality in the management of mandibular ORN following irradiation.Copyright: © 2023 Annals of Maxillofacial Surgery.