牵张成骨关闭牙槽突裂的实验研究及组织学观察

目的:应用牵张成骨技术进行牙槽突裂关闭术,观测牙槽突裂硬软组织修复效果和牵张间隙新骨生成的过程、机制,探索一种牙槽突裂整复治疗的新途径。方法:以10只成年杂种犬为实验对象,建立人工上颌牙槽突裂的动物模型,其中2只为对照组。另8只为实验组,以牙骨复合体作为转运盘,以每次0.4mm,2次/天的速度沿牙弓方向行牵张成骨术,直到关闭硬组织裂隙。于原位固定0,14,28,63天分别处死动物各2只,对标本进行X线摄片、大体和组织学观察。结果:利用牵张成骨术成功地进行牙槽突裂整复术,硬组织裂隙关闭, 同时软组织得到扩张;骨牵张间隙完全被新生骨组织取代并沿牵张方向生长,随固定时间的延长改建、成熟。结论:牵张成骨术提供了牙槽突裂治疗的新途径,新骨的生成是膜内成骨方式。

Distraction osteogenesis for repair of alveolar cleft: an experimental study and observation of histology

Objective To observe the repair of alveolar cleft (AC) bone defect by distraction osteogenesis(DO); to observe the course and the mechanism of the new bone generated and matured by histological observation;to find a credible new treatment for reconstruction of alveolar cleft or bone defect. Methods 10 dogs were used to make experimental model of AC in the study. 2 were experimental control group; 8 were experimental group, the tooth-bone complex transport disc(TD) were performed by vertical interdental and horizontal subapical osteotomy. The gradual distraction was performed at the rate of 0.4mm twice a day till the TD reached the opposite edge of the AC. On the 0, 14, 28, 63 day after completion of distraction the animals were sacrificed X-ray and histological observation were performed. Results All the examinations revealed the TD recombination to the opposite edge of the AC, simultaneously, the proportional expansion of overlay mucoperiosteal flap was achieved. The distraction gap was bridged. New bone was generated along the distraction direction and remodeled and matured ultimately. Conclusion The study results suggested that DO could be a new treatment for AC hard and soft tissue defect. The formation of new bone was intramembrane osteogenesis.