腭横缝牵张成骨延长硬腭的实验研究

目的传统腭裂软组织后推延长手术由于瘢痕挛缩和缺乏骨性支持而难以维持软腭的正常长度、位置和发育,手术损伤和瘢痕还导致面部生长障碍。本研究旨在用缝牵张技术延长硬腭,以避免传统手术存在的语音和面部发育问题。方法 8周龄杂种犬6只,腭骨内种置汞齐标记,用 NiTi-SMA 弓形牵张器前后方向牵张一侧腭横缝。维持8周。经临床,X 线,干骨观察缝牵张后变化。结果 4周时腭横缝牵张达到预定限度。X 线片显示,牵张侧腭横缝前后两点汞齐标志的间距增加1.5cm;前颌在牵张早期显著前突,随后逐渐回缩至两侧平齐。9个月头颅干骨发现,牵张侧腭骨后缘明显后移,上颌骨前移,鼻腭孔至硬腭后缘的距离较对侧增加4.6～5.9mm。结论腭横缝牵张可以造成永久性腭骨后退和上颌前移。     

腭横缝牵张成骨延长硬腭的实验研究

目的 传统腭裂软组织推延长手术由于瘢痕挛缩和缺乏骨性支持而难以维持软腭的下沉长度、位置和发育,手术损伤和瘢痕还导致面部生长障碍。本研究旨在用缝牵张技术延长硬腭,以避免传统手术存在的语音和面部发育问题。方法 ８周龄杂种犬６只,腭骨内种置汞齐标记标记用ＮiＴi－ＳＭＡ弓形牵张器前后方程方向牵张一侧腭横缝,维持８周。经临床,Ｘ线,干骨观察缝张后变化。结果 ４周时腭横缝和达到预定限度。Ｘ线片显示,牵张侧腭横     

腭骨外侧缝牵张成骨闭合硬腭后部裂

目的 探索腭裂修复新方法,采用缝牵张技术诱导犬腭骨外侧缝骨再生,补偿腭裂骨组织缺损,形成硬腭后部的骨性修复,避免传统手术的语音效果较差和面部发育障碍的不足。方法 用８周龄杂种犬９只,实验组经手术形成硬腭８ｍｍ宽的裂隙。用牵张力分别为２００ｇ、３６０ｇ和４８０ｇ的镍钛形状合金缝牵张器牵张腭骨外侧缝,使两侧腭骨向中线移动关闭裂隙。并设实验对照组和空白对照组。结果 实验对照组腭裂比手术时略有扩大;实验组     

腭骨外侧缝牵张成骨闭合硬腭后部裂(动物实验研究)

目的探索腭裂修复新方法,采用缝牵张技术诱导犬腭骨外侧缝骨再生,补偿腭裂骨组织缺损,形成硬腭后部的骨性修复,避免传统手术存在的语音效果较差和面部发育障碍的不足。方法用８周龄杂种犬９只,实验组经手术形成硬腭８ｍｍ宽的裂隙。用牵张力分别为２００ｇ,３６０ｇ和４８０ｇ的镍钛形状记忆合金（ＮｉＴｉ－ＳＭＡ）缝牵张器牵张腭骨外侧缝,使两侧腭骨向中线移动关闭裂隙。并设实验对照组和空白对照组。结果实验对照组腭裂比手术时略有扩大;实验组则先后完全闭合,组织学发现实验组缝的骨缘有明显新骨形成。结论幼犬腭裂可以通过缝牵张诱导骨组织再生补偿缺损,形成骨性修复;ＮｉＴｉＳＭＡ缝牵张器具有稳定可靠的牵张作用;三种不同牵张力值均能诱发缝区大量新骨形成,牵张力值较大者形成的新骨骨髓腔较大,骨小梁细长。     

腭骨外侧缝牵张成骨闭合硬腭后部裂(动物实验研究)

目的探索腭裂修复新方法,采用缝牵张技术诱导犬腭骨外侧缝骨再生,补偿腭裂骨组织缺损,形成硬腭后部的骨性修复,避免传统手术存在的语音效果较差和面部发育障碍的不足。方法用8周龄杂种犬9只,实验组经手术形成硬腭8mm 宽的裂隙。用牵张力分别为200g,360g和480g 的镍钛形状记忆合金(NiTi-SMA)缝牵张器牵张腭骨外侧缝,使两侧腭骨向中线移动关闭裂隙。并设实验对照组和空白对照组。结果实验对照组腭裂比手术时略有扩大;实验组则先后完全闭合,组织学发现实验组缝的骨缘有明显新骨形成。结论幼犬腭裂可以通过缝牵张诱导骨组织再生补偿缺损,形成骨性修复;NiTi-SMA 缝牵张器具有稳定可靠的牵张作用;三种不同牵张力值均能诱发缝区大量新骨形成,牵张力值较大者形成的新骨骨髓腔较大,骨小梁细长。     

腭横缝牵张环上颌缝组织学研究

目的了解腭横缝牵张后各有关缝的组织学变化及其与上颌各部结构变动的关系。方法采用四环素荧光标记和组织学方法对腭横缝牵张犬和相同年龄的正常犬腭横缝,颧颌缝,颧颞缝,额颌缝和前颌缝等进行观察。结果正常幼犬各缝成骨活动较活跃,随年龄增加缝细胞成分减少。实验犬则表现成骨细胞和成纤维细胞剧增,新骨和结缔组织纤维循张力方向排列。腭横缝分离宽度最大,新生骨质最多;颧颌缝和额颌缝由于多骨性交错,骨沉积和骨吸收同时存在;颧颞缝新生骨小梁和胶原纤维由于滑动而改变排列方向;前颌缝表现牵张侧受压呈退行性变,对侧呈增殖性改变。结论腭横缝牵张可以诱发环上颌诸缝广泛的组织反应;各缝因受力大小和方向不同而呈现多样性反应。     

腭横缝牵张环上颌缝组织学研究

目的　了解腭横缝牵张后各有关缝的组织学变化及其与上颌各部结构变动的关系。方法　采用四环素荧光标记和组织学方法对腭横缝牵张犬和相同年龄的正常犬腭横缝，颧颌缝，颧颞缝，额颌缝和前颌缝等进行观察。结果　正常幼犬各缝成骨活动较活跃，随年龄增加缝细胞成分减少。实验犬则表现成骨细胞和成纤维细胞剧增，新骨和结缔组织纤维循张力方向排列。腭横缝分离宽度最大，新生骨质最多；颧颌缝和额颌缝由于多骨性交错，骨沉积和骨吸收同时存在；颧颞缝新生骨小梁和胶原纤维由于滑动而改变排列方向；前颌缝表现牵张侧受压呈退行性变，对侧呈增殖性改变。结论　腭横缝牵张可以诱发环上颌诸缝广泛的组织反应；各缝因受力大小和方向不同而呈现多样性反应。     

腭骨外侧缝牵张成骨关闭硬腭裂的长期效果和对颌面发育 …

目的 了解腭骨外侧缝牵张的长期效果和对颌面发育的影响。方法 采用头颅测量方法对经过腭骨外侧缝牵张的６只和正常对照８只Ｂｅａｇｌｅ犬进行观察和分析。结果 所有实验组犬两侧腭骨水平板均在中线形成骨性愈合。两组动物面长度和高度变量无明显差异，实验组面宽度，腭骨水平板宽度和垂反间距均小于对照组，差异具有显著性意义。结论 采用腭骨外侧缝牵张成骨的方法，能够使缺裂的腭骨板形成永久而完善的骨性修复；对在长度和高     

硬腭两维牵张成骨的动物实验研究

目的：通过手术建立犬腭裂实验动物模型,探讨应用自行设计制作的腭骨外固定两维牵张器关闭硬腭骨裂隙和后退腭骨的可行性。方法：选择7只年龄在1～1.5岁的健康杂种犬作为研究对象。并采用随机分组的方法抽取2只为对照组,其余5只作为实验组。通过手术制造10mm×25mm的人工腭裂模型,观察对照组能否自然愈合。在实验组采用自行设计制作的硬腭两维骨牵张器,通过骨牵张关闭裂隙并延长硬腭骨,观察牵张过程。结果：实验犬术后均成活、健康状况良好,实验组牵张器固定牢靠,顺利关闭约10mm的间隙,硬腭骨延长约12mm,对照组裂隙无明显变化。结论：设计的硬腭两维牵张器,具有稳定可靠的牵张作用,可以同时关闭裂隙和延长硬腭骨,为修复腭裂提供了一种新的途径。     

镍钛记忆合金牵张犬腭骨-上颌骨缝超微结构的研究

目的 利用透射电镜观察不同时间段犬腭骨-上颌骨缝内细胞超微结构的变化,以探索颅面部骨缝组织在张力作用下的变化.方法 制作镍钛形状记忆合金(NiTi-SMA)扩张器,并用口腔矫形测力器测定其最大力值为3.5 N.选择8周龄杂种犬45只,随机分为空白对照组、实验对照组、实验组.实验对照组和实验组在全麻下,去除硬腭中部后部骨质,缝合口腔和鼻腔侧黏膜,形成宽约8 mm的腭裂模型.实验组将NiTi-SMA安置在硬腭上,分别于牵张后3、7、14、28、56 d处死动物,并制作电镜标本.透射电镜下观察腭骨-上颌骨缝内细胞的变化过程.结果 电镜下腭骨-上颌骨缝牵张,首先表现为组织断裂,渗出,细胞死亡,随后是骨和纤维生成细胞群增殖活跃,成骨细胞和成纤维细胞功能增强,最终恢复正常缝组织结构.结论 电镜下可以区分缝细胞的类型和功能状态,提示缝牵张是组织修复与再生并存的过程,张力引发细胞反应特别是成骨反应是导致骨缝增宽的主要因素.     

腭横缝牵张环上颌缝组织琛

OBJECTIVE: This study was carried out to investigate the histological reactions of midfacial sutures induced by transverse palatal suture expansion. METHODS: Nine mongrel dogs of 8-week old were used in the study. Six of them were used as experimental group as described in a previous paper. The additional three served as controls. In the experimental dogs, a NiTi-shape memory alloy (NiTi-SMA) arch wire was used to expand the transverse palatal suture. Tetracycline was injected intramuscularly (50 mg/kg) three days before operation and at the time of sacrifice. Tissue reactions of premaxillo-maxillary suture, transverse palatal suture, zygomatico-maxillary suture, zygomatico-temporal suture and fronto-maxillary suture were observed in undecalcified tetracycline labeled sections and decalcified histological sections. RESULTS: The sutures in normal young dogs showed active bone formation. With the increase of age, the cellular components of the suture decreased. A great amount of new bone apposition was found in the bony front of expanded transverse palatal suture of the experimental dogs. Degenerative changes were found in premaxillo-maxillary suture at the expanded side while the contralateral showed active osteogenesis. Other sutures manifested both bone apposition and deposition due to the irregular interdigitations. CONCLUSION: After expansion, a great amount of new bone formed in the transverse palatal suture and thus the hard palate was lengthened. All the circum-maxillary sutures reacted in different patterns.     

THE HEALING PROCESS OF PALATAL TISSUES AFTER OPERATIONS WITH AND WITHOUT DENUDATION OF BONE: AN EXPERIMENTAL STUDY IN DOGS

The aim of this study was to evaluate wound healing clinically and histologically in beagle dogs after palatal repair during growth by the partially split flap technique and the von Langenbeck technique. A standardised soft tissue defect was created in the medial region of the palate. The partially split flap technique was performed in 14 dogs (age 12 weeks). Von Langenbeck repair was simulated in 12 dogs (age 12 weeks). Four dogs (age 12 weeks) served as controls. Standardised slides of the palate were taken on eight occasions and the wound surface areas were measured. Histological sections were prepared at three different ages. The animals were studied until the age of 25 weeks. Re-epithelialisation was complete in roughly two weeks in dogs after palatal repair by the partially split flap technique. The histological features of this group were close to normal limits. After the von Langenbeck's procedure re-epithelialisation took about three weeks and scar tissue was firmly attached to bundle bone by Sharpey's fibres. We conclude that the histological appearance of the palatal tissues in dogs after palatal repair during growth by the partially split flap technique was close to normal. We assume that this is reason for more favourable dentoalveolar development after the partially split flap technique compared with von Langenbeck's repair.     

The healing process of palatal tissues after operations with and without denudation of bone: an experimental study in dogs.

The aim of this study was to evaluate wound healing clinically and histologically in beagle dogs after palatal repair during growth by the partially split flap technique and the von Langenbeck technique. A standardised soft tissue defect was created in the medial region of the palate. The partially split flap technique was performed in 14 dogs (age 12 weeks). Von Langenbeck repair was simulated in 12 dogs (age 12 weeks). Four dogs (age 12 weeks) served as controls. Standardised slides of the palate were taken on eight occasions and the wound surface areas were measured. Histological sections were prepared at three different ages. The animals were studied until the age of 25 weeks. Re-epithelialisation was complete in roughly two weeks in dogs after palatal repair by the partially split flap technique. The histological features of this group were close to normal limits. After the von Langenbeck's procedure re-epithelialisation took about three weeks and scar tissue was firmly attached to bundle bone by Sharpey's fibres. We conclude that the histological appearance of the palatal tissues in dogs after palatal repair during growth by the partially split flap technique was close to normal. We assume that this is reason for more favourable dentoalveolar development after the partially split flap technique compared with von Langenbeck's repair.     

持续弹力牵引成骨修复腭裂的实验研究

目的：应用持续弹力牵引成骨技术进行封闭腭裂、延长硬腭的实验研究，探讨以组织新生方式修复腭裂的可行性。方法：6个月龄杂种犬10只，随机分为空白对照组、实验对照组、实验组。实验组人工制备宽8mm、长25mm硬腭裂隙，腭骨水平板周围切骨，经5d的间歇期后安置记忆合金牵引器，向后、向中线牵引，达到预期结果后，牵引器继续保持8周。结果：实验对照组裂隙无明显变化。实验组裂隙逐渐缩窄，裂隙后部于2－3周封闭，裂隙前部缩窄为1－2mm的缝隙，同时硬腭向后延长；组织学证实骨牵引区域完全为新生骨组织所填充。结论：持续弹力牵引成骨能够诱导腭裂犬腭骨和附着的软组织新生，有效封闭腭部裂隙、延长硬腭。     

Furlow反向双Z法腭裂修复术后腭瘘发生率的研究

目的：研究腭裂Furlow术后瘘的发生率以及影响因素。方法：对53例腭裂修复术后瘘的发生率和可能影响瘘发生的因素如性别、年龄、腭裂类型、裂隙的程度进行回顾性研究。结果：总瘘孔率为18.86%（10/53）,瘘孔率最高为硬腭前部（64%）,其次为软硬腭交界处及硬腭部（分别为18%）,瘘孔率最低为软腭区域（0%）（P〈0.05）。男性与女性患者瘘的发生率无统计学上差异（P〉0.05）。单侧完全性腭裂组（UCCLP,24%）和双侧完全性腭裂组（BCCLP,36.7%）瘘发生率高于硬软腭裂组（HSCP,0%）和软腭裂组（SCP,0%）,但无统计学上差异（P〉0.05）,完全性腭裂组瘘的发生率高于不完全性腭裂组（P〈0.05）。结论：腭裂术后腭瘘的发生与腭裂的类型有关,Furlow术式修复腭裂可减少软腭、软硬腭交界处的腭瘘发生率。但相对的有增加完全性腭裂硬腭前部腭瘘发生率的可能。