输送盘牵张成骨术重建下颌髁突后对下颌骨生长发育的影响  

Effects of mandibular condyle reconstruction by transport distraction osteogenesis on mandibular bone growth in goats

作　　者：马永清[1] 祝颂松[1] 胡静[1] 李继华[1] 应彬彬[2] 

机构地区：[1]成都四川大学华西口腔医学院口腔颌面外科,610041 [2]浙江省人民医院

出　　处：《实用口腔医学杂志》2008年第2期161-164,共4页Journal of Practical Stomatology

基　　金：教育部跨世纪优秀人才基金资助(编号:教技函2002-48)

摘　　要：目的:研究输送盘牵张成骨术重建下颌髁突后对下颌骨生长发育的影响。方法:选用3～4月龄健康幼年雄性山羊16只,手术切除右侧髁突(保留关节盘),在右下颌升支行反"L"形骨切开术形成骨输送盘,并安置牵张器。以每日2次,每次0.4mm的速率向上牵引输送盘至关节窝。在手术后当天、牵张结束后当天、牵张结束后4、12、24、48周时行三维CT检查评价输送盘改建及牵张间隙内新骨形成情况,并分别于12、24、48周3个时间点各处死动物2只对新生髁突做组织学检查。牵张结束后48周时处死剩余10只动物,对下颌骨及重建髁突形态进行观察与测量。左侧下颌骨作为正常对照组。结果:三维CT显示新生髁突形态逐渐改建并接近正常髁突,牵张间隙新骨生成良好。大体观察发现新生髁突体积较正常侧明显增大,但下颌骨的生长与正常侧无显著差异。新生髁突表面有一层纤维软骨覆盖,组织学结构与正常关节软骨类似。结论:输送盘牵张成骨重建髁突未对下颌骨的生长发育产生明显影响;下颌运动产生的功能刺激是下颌骨继续生长发育的主要原因。Objective：To investigate the effects of mandibular condyle reconstruction by transport distraction osteogenesis on mandibular bone growth in goats.Methods：Sixteen 3-4 months juvenile male goats were used.The right condyles were extirpated with the articular discs reserved,and transport distraction osteogenesis was performed to reconstruct the mandibular condyle.The left mandibular condyles served as control.3D-CT examination was performed at different intervals.Two goats were randomly sacrificed respectively at 12,24 and 48 week for histological observation after completion of distraction.48 weeks after completion of distraction,the remaining goats were sacrificed for mandibular growth measurement.Results：The hemimandible of the distracted side exhibited similarities to the contralateral side except the larger neocondyles.There was no significant difference on the mandibular body and ramus between two sides.A well-organized fibrocartilage was seen at the neocondylar surface over time.Conclusion：A neocondyle reconstructed by transport distraction has the potential to grow under functional stimuli of the temporomandibular joint.

关 键 词：输送盘 牵张成骨 生长 下颌髁突 重建 

分 类 号：R782[医药卫生—口腔医学]