上颌骨缝牵张的组织学变化  

Histological changes during expansion of the maxillary suture

作　　者：商洪涛[1] 刘锐[1] 孙建壮[1] 赵晋龙[1] 刘彦普[1] 

机构地区：[1]解放军第四军医大学口腔医学院颌面外科,陕西省西安市710032

出　　处：《中国组织工程研究与临床康复》2007年第10期1833-1836,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的:观察缝牵张过程中环上颌骨缝的组织反应和组织再生机制。方法:实验于2005-03/09在解放军第四军医大学口腔医学院颌面外科实验室完成。15周龄杂种犬12只,随机数字法分为实验组8只,对照组4只。实验组安置口外自制牵引支架,自鼻腭孔引出牵引钩,橡皮圈连接牵引支架和牵引钩,向前持续弹性牵引,牵引力约600g。牵引1周和4周时,各处死实验组犬4只和对照组犬2只,对前颌缝,腭横缝,颧颌缝,颧颞缝区组织作大体观察和组织学观察。结果:实验犬12只均进入结果分析。①骨缝区成骨主要发生在侧带与骨缘之间,缝牵张初期骨缘外侧出现囊状分离带,成骨细胞与成纤维细胞大量增殖,新骨与结缔组织纤维排列方向与牵引力方向基本平行。②中央带纤维较致密,在牵引过程中,纤维排列方式未发生明显变化,而起到了屏障作用,阻止了缝骨性融合的发生。③牵张早期,缝区组织同时可见Ⅰ和Ⅲ型胶原,随后成骨细胞在Ⅲ型胶原基质的基础上分泌沉积Ⅰ型胶原而成骨,最终Ⅲ型胶原降解,Ⅰ型胶原完全代替Ⅲ型胶原成为骨基质的主要成份。缝区组织天狼猩红染色未见Ⅱ型胶原。结论:缝牵张成骨是以膜内成骨方式为主,无明显的软骨内成骨现象。中央带具有屏障作用,阻止牵张过程中骨缝发生骨性融合。AIM： To observe the process of tissue response and regeneration in the circum-maxillary sutures under tensile forces. METHODS： The experiment was conducted in the laboratory of Department of Oral and MaxiUofacial Surgery, Stomatology College, Forth Military Medical University from March to September 2005. Twelve 15-week mongrel dogs were randomly assigned into experimental group （n =8） and control group （n =4）. The experimental group was fitted with an extra-oral traction device and a traction hook was exerted from the nasopalatine foramen; a rubber band was used to connect the scaffold and the traction hook and a forward elastic force was exerted with 600 g tensile force. After 1 and 4 weeks, 4 dogs in the experimental group and 2 dogs in the control group were killed respectively to observe the maxillary suture, palatine suture, malomaxillary suture and zygomaticotemporal suture grossly and histologically. RESULTS： All the 12 dogs were involved in the result analysis. ①The bone formation was found between lateral band and bone margin, and a cyst-like zone appeared between the bony front and the suture connective tissue at the early stage of sutural expansion. Then a great amount of osteoblasts and fibrolasts proliferated. New bone and connective tissue fiber paralleled with the direction of tensile force. ②Fiber in intermediate zone in suture arranged intensively, and had no markedly changes during sutural expansion, which prevented the sutural bone from fusion. ③At the early stage of sutural expansion, Ⅰ and Ⅲ collogen could be found in suture regions; then the osteoblasts secreted Ⅰ collogen besides Ⅲ collogen, and finally, Ⅲ collogen degradated, which was replaced by Ⅰ collogen as the main components of bore matrix, Ⅱ collogen was not found in suture region after picroirius staining. CONCLUSION： Suture expansion is a process of membrane bone formation without enchondral bone formation. Intermediate zone in suture can prevent fusion of bone as a barrier.

关 键 词：上颌骨 引导组织再生术 组织学 比较 

分 类 号：R714.257[医药卫生—妇产科学]