双维控制牙槽骨牵ava张器的研制及动物实验研究

背景：牵张成骨增高牙槽嵴在基础研究及临床已有很多成功报道,双维控制垂直牙槽骨牵张器可有效防止单向直线牵张器行牙槽骨牵张发生轴向移位。目的：研制双维控制的牙槽骨牵张器,并通过动物实验观察其成骨效应。方法：选择杂种犬4只,拔除一侧下颌前磨牙形成萎缩牙槽骨模型。1个月后行骨切开放置双维牵张器,7 d后垂直牵张 (1 mm/d,共5 d)。完成垂直牵张后,利用双维牵张器颊向控制功能将移动骨块颊向牵出(大约2.4 mm),固定2个月后行大体观察及组织学检查。结果与结论：4只犬中2只黏膜伤口愈合良好,2只黏膜出现裂开,行二次缝合后愈合,牵张器固位良好,未出现松动、脱落。牵张骨块向垂直向及颊向的位移量满足实验目的要求,牙槽骨垂直向高度平均增加(5.0±0.2) mm,颊向宽度平均增加(2.4±0.3) mm。大体观察及组织学检查均证实牵张成骨的骨块新骨形成良好。说明双维控制垂直牙槽骨牵张器能较好的控制移动骨块垂直或颊向的移动方向,并且新骨形成良好。

A bidirectional alveolar bone distraction device for osteogenesis of alveolar bone

BACKGROUND: Alveolar bone augmentation using a unidirectional distraction device may lead to axial displacement. A bidirectional distraction device can control the vertical and buccal-lingual directions. But studies regarding this have been rarely reported. OBJECTIVE: To develop a bidirectional alveolar bone distraction device and to investigate its effects on osteogenic effects through an animal experiment. METHODS: Four adult mongrel dogs were established into models of alveolar bone atrophy by extraction of unilateral mandible premolars. After 1 month, alveolar bone was cut open and a bilateral distraction device was placed. Seven days later, the distraction was started at a rate of 1 mm/day for 5 days. At last, buccal-lingual direction distraction (approximately 2.4 mm) was taken for once, followed by a consolidation period of 2 months. Subsequently, gross observation and histological examination of samples were performed. RESULTS AND CONCLUSION: Among the four dogs, mucous membrane wound was well healed in two dogs, and wound dehiscence was observed in two dogs but healed after secondary debridement and suture. No loosening of distraction devices was observed. The segments were augmented (5.0±0.2) mm in alveolar direction and (2.4±0.3) mm in buccal direction. There were newly formed bones as shown by gross observation and histological examination. Results suggest that a bidirectional distraction device can well control the transport bone in alveolar and buccal-lingual directions and promote new bone formation.