吻合旋股外侧血管髂骨移植在颌面部的应用

吻合血管髂骨移植是修复颌骨缺损的常用手术。作者应用吻合旋股外侧血管升支髂骨瓣移植修复颌面部骨缺损４例，证实以该血管为蒂的髂骨瓣的临床可行性。旋股外侧血管升支位置恒定、血管口径较粗，所形成的血管蒂较长，操作安全、方便。作者认为以该血管为蒂的髂骨移植是颌骨缺损修复的可供选择术式之一。本文对该髂骨瓣的血供、手术注意点等进行了讨论。     

外科模板在游离腓骨瓣修复上颌骨缺损术中的应用

目的 探讨外科模板在上颌骨切除同期自体腓骨瓣移植修复术中的作用。方法 7例因上颌骨肿瘤需行上颌骨切除术并同期自体腓骨瓣修复的患者，术前取研究模型，根据拟行的手术范围进行模型外科设计，确定牙槽突缺损范围，并将模型修整成需要重建的理想解剖形态，制作模板。外科医生在术中根据模板对腓骨瓣塑形，并确定腓骨瓣固定的位置。术后取研究模型观测腓骨瓣的就位情况，三维CT评价腓骨与下颌骨的相对位置关系。结果 经过外科模板的术中定位，腓骨瓣与下颌骨达到正常相对位置关系，垂直向间隙适合常规叉齿或种植义齿修复。患者戴用义齿后的咀嚼效率明显提高。结论 外科模板是修复医生和外科医生之间有效的交流载体，为患者术后功能和外形的恢复创造了有利条件。     

Scintigraphic detection of metastatic bone lesions from breast carcinoma: Report of a case

A 46-year-old woman with extensive skeletal metastases from primary breast carcinoma was examined scintigraphically using^99mTc HMDP. The skeletal metastatic lesions, except for the mandible and hip joint, were clinically asymptomatic and hardly detected radiographically. Marked accumulation of^99mTc HMDP was shown in both the asymptomatic and symptomatic lesions, and scintigraphy is also a useful imaging modality for the identification of whole body metastatic bone lesions, especially in the early stage.     

类风湿性关节炎患者牙周骨丧失程度的临床研究

目的:揭示类风湿性关节炎患者关节炎严重程度与牙周骨丧失程度的相关性。方法: 70例类风湿关节炎患者根据牙周附着丧失与牙槽骨吸收程度分为2组:无、轻度骨丧失组和中、重度骨丧失组。分别检查患者晨僵持续时间、红细胞沉降率以及血清C反应蛋白,并进行分析。结果:经统计学分析, 2组在晨僵时间、红细胞沉降率及C反应蛋白水平均有显著性差异,中、重度组均高于无、轻度组。结论:类风湿关节炎患者牙周骨丧失的程度与其类风湿临床症状严重程度密切相关。     

BMSC-HA/TCP修复羟基磷灰石种植体周围骨缺损的实验研究

目的:探讨应用小型猪BMSC为种子细胞,HA-TCP为支架修复种植体周围骨缺损的可行性。方法:将8只小型猪,随机分为实验组及对照组。在两组种植体周围骨缺损区分别植入细胞-支架材料,单纯支架材料,于种植体植入后1个月,3个月取材,进行观察。结果:细胞-支架组1个月骨缺损区可见新生编织骨包绕支架材料,3个月可见支架材料降解,密质骨形成。支架组1个月骨缺损区纤维组织包裹支架材料,3个月支架材料部分降解。结论:细胞-支架构建方式可作为修复羟基磷灰石种植体周围骨缺损的方法之一。     

牙槽突裂骨移植稳定性的研究进展

牙槽突裂自体骨移植术是目前常用的修复唇腭裂患者牙槽突骨缺损的手术方法，但术后常存在植入骨再吸收现象。植骨时机、植入骨骨源、裂隙的结构、牙周健康状况和术后并发症等多种因素对手术成功率均有影响，通过加入生长因子和牵引成骨等方法，可增加移植骨的稳定性。作者就有关影响植入骨稳定性的因素及增加移植骨稳定性方法的研究进展作一综述。     

颊粘膜肌瓣单独或联合颊脂垫修复舌腭缺损

应用颊粘膜瓣单独或联合颊脂垫修复舌腭缺损是一种简单而有效的手术方法。笔者自１９３９年至１９９６年，应用该方法修复舌癌切除后≤１／２舌缺损１０例，修复软腭缺损２例。瓣全部成活，吞咽、语言功能恢复快，外形满意。术后几天开口约１．５ＣＭ～２．０ｃｍ，２周后张口逐渐恢复正常。本技术为舌半侧以内缺损和软腭缺损的修复提供了可靠实用的新方法。     

Osteoclast formation from mouse bone marrow cells on micro/nano-scale patterned surfaces

ObjectivesOsteoclasts can sense the surface topography of materials. However, it is difficult to identify the structural factors that affect osteoclast formation and its function. Furthermore, we hypothesized that the type of osteoclast precursor cells also affects osteoclastogenesis in the materials. In this study, we investigated the effects of defined micro/nanoscale patterns on osteoclastogenesis from bone marrow cells (BMCs).MethodsVarious cyclo-olefin polymer (COP) patterns were prepared using nanoimprinting. The effects of shape, size, and height of the patterns, and the wettability of the patterned surfaces on osteoclastogenesis from BMCs were evaluated in vitro.ResultsOsteoclast formation was promoted on pillars (diameter, 1 μm or 500 nm; height, 500 nm). Notably, osteoclastogenesis from BMCs was better promoted on hydrophobic pillars than on hydrophilic pillars. In contrast, decreased osteoclast formation was observed on the nanopillars (diameter, 100 nm; height, 200 nm).ConclusionsWe demonstrated the promotion of osteoclast formation from BMCs on hydrophobic pillars with diameters of 1 μm and 500 nm. Some cellular behaviors in the patterns were dependent on the type of osteoclast precursor cells. The designed patterns are useful for designing the surface of dental implants or bone replacement materials with a controllable balance between osteoblast and osteoclast activities.     

骨形成蛋白家族与牵引成骨术

牵引成骨术(DO)中新骨的形成具有胚胎骨的发生和正常骨折愈合的某些特征,骨形成蛋白家族(BMPs)在其中扮演了重要角色。本文就BMPs与DO的生物学联系、作用调节机制、外源性BMPs的应用等方面作一综述。     

类骨质羟基磷灰石修复骨缺损的实验研究

目的:了解类骨质羟基磷灰石(OHA)的生物相容性,初步探讨其作为骨替代材料的可行性。方法:12只新西兰白兔随机分为4组,在双侧股骨内侧髁形成9mm×4mm×5mm大小的缺损,分别植入OHA和对照材料,术后2、4、8、12周取标本,进行大体标本、X线、组织学切片、扫描电镜观察及成骨面积的定量分析。结果:实验组成骨细胞易于粘附、生长、增殖,骨小梁形成钙化早,新骨面积百分比高于对照组,差异有统计学意义。结论:类骨质羟基磷灰石是一种良好的骨替代材料,具有广阔的应用前景。