牵引成骨重建缺损山羊下颌骨髁突的实验研究  

Experimental study on reconstruction of goat condylar defect using distraction osteogenesis

作　　者：杨辛[1] 沈国芳[2] 张志愿[2] 杨小平[1] 廖贵清[1] 曾融生[1] 

机构地区：[1]中山大学光华口腔医学院口腔颌面外科中山大学口腔医学研究所,广东广州510055 [2]上海交通大学医学院附属第九人民医院.口腔医学院口腔颌面外科,上海200011

出　　处：《中国口腔颌面外科杂志》2008年第4期285-291,共7页China Journal of Oral and Maxillofacial Surgery

基　　金：上海市重点(优势)学科建设项目(Y0203);国家高技术研究发展计划(863计划)项目(2002AA205011);上海市教育委员会科研基金(01BZ02);上海市教育委员会启明星后计划项目(06QH14009);~~

摘　　要：目的:通过建立山羊牵引成骨延长下颌支重建下颌支高度动物模型,对山羊下颌支牵引成骨区新骨的组织及组织形态学进行观察,为牵引成骨术在下颌支缺损区的临床应用提供理论依据。方法:12只山羊随机分为4组,每组3只。实验用山羊在下颌切迹下方截骨,切除一侧髁突及其颈部,左右随机。再于下颌支后缘形成转移盘。牵引延长下颌支,于牵引结束后2、4、8、12周分别进行大体、组织学及组织形态学观察,并用Axioplan2imaging显微图像分析系统进行处理,结果采用SPSS12.0软件包进行t检验。结果:从牵引结束后4周始,通过牵引成骨形成的新髁突已经具备与正常山羊髁突相似的外形;组织学及组织形态学结果显示,牵引区新骨随时间推移,钙化程度增加。至牵引结束后6周时,牵引区新骨矿化率为(1.35±0.57)μm/d,已经接近正常山羊下颌支矿化率(0.95±0.13)μm/d(P>0.05)。结论:以山羊作为下颌支及髁突缺损牵引成骨重建动物模型具有较好的重复性,与临床情况具有相似性。牵引结束后6周,可以考虑拆除牵引器,以利新骨在生理状态下进行功能改建。PURPOSE： To evaluate the formation of new bone of distraction area of goat condylar defect. METHODS： Twelve goats were divided randomly into 4 groups, three goats in each group.In the experimental goat, the mandibular condyle of one side was surgically removed and a transport disc was made, a custom-made distractor was implanted. After a five-day latent period, the distraction was activated at a rate of 0.8mm per day, until a certain height was achieved. Three goats were sacrificed at 2 weeks, 4 weeks, 8 weeks and 12 weeks, and the specimen of the new formed bone were investigated radiographically and pathohistologically. The measurements were made using Axioplan2 imaging analysis system and the data was statistically analysed with SPSS12.0 software package for students t test. RESULTS： The shape of the new formed condyle of all goats was similar to the normal ones morphologically; the new formed bone of distraction area calcified gradually with time, and the degree of calcification was similar to the normal ramus from 6 weeks after distraction. The miner rate was （1.35±0.57）μm/d and （0.95±0.13）μm/d respectively, which was similar between the new formative bone 6 weeks post distraction and the normal one （P〉0.05）. CONCLUSIONS： A model of distraction osteogenesis for reconstruction the condylar defect and ramus is successfully established. The appliance of distraction can be removed 6 weeks after distraction for the new bone reformed under the normal circumstances.

关 键 词：牵引成骨 髁突缺损 动物模型 山羊 

分 类 号：R782.4[医药卫生—口腔医学]