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     

腭骨外侧缝牵张成骨的连续组织学研究

目的　了解腭骨外侧缝牵张的缝组织反应和组织再生机理。方法　采用NiTi SMA缝牵张器牵张幼犬双侧腭骨外侧缝 ,四环素荧光标记和组织学观察缝牵张 3 ,7,14 ,2 8,5 6d连续组织变化过程。结果　缝牵张初期骨缘外侧出现囊状分离带 ,此后成骨和成纤维细胞大量增殖 ,成骨活动沿囊性分隔和周边进行 ,直至新的骨缘形成 ,缝恢复正常形态。结论　缝成骨主要发生在骨缘与缝结缔组织交界处 ,骨组织再生极具空间效率 ,中央带纤维排列方式和修复可能具有屏障作用 ,阻止了跨缝骨性融合。     

上颌骨缝牵张的实验研究

目的:探讨缝牵张治疗面中部发育不全的新方法。方法:15周龄杂种犬12只,随机分为一周实验组4只,一周对照组2只,4周实验组4只,4周对照组2只。分别在4组犬的前颌缝,腭横缝,颧颌缝,颧颞缝的两侧置入钛钉作为标志。实验组安置自制口外牵引支架,自鼻腭孔引出牵引钩,橡皮圈连接牵引支架和牵引钩,分别持续弹性牵引1周和4周,牵引力约0.6kg。牵引前后拍X线片测量骨缝两侧标志钉间距离及颅底角的大小。牵引结束时将4组犬处死,进行测量与统计学分析。结果:上颌骨逐渐前移,咬合关系呈II类错。骨缝两侧标志钉间距离测量结果提示,牵引1周时,腭横缝、颧颌缝首先对牵引力发生反应而扩增,牵引四周时,前颌缝、腭横缝标志钉间距离增加值最大。各组间颅底角变化不明显,上颌骨未发生旋转。结论:缝牵张可以有效地前移上颌骨,并避免上颌在移动过程中发生旋转。     

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.     

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。     

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.