几丁质/rhBMP2/胶原复合物修复骨缺损的实验研究

目的：研究几丁质作为骨缺损充填材料和rhBMP2载体的可行性。方法：制备多孔几丁质及几丁质/rhBMP2/胶原复合物，进行了几丁质，几丁质/rhBMP2/胶原复合物修复兔颅骨缺损的实验研究。通过X线片，组织学检查评价其骨缺损修复能力。结果：实验结果表明几丁质具有一定的骨引导活性，与rhBMP2复合后，成为既具有骨引导活性，又具有骨诱导活性的复合植骨材料，具有较强的骨缺损修复能力。结论：几丁质适于作为骨替代材料及BMP的载体，但在材料的强度和表面活性上还需要改进。     

Influence of occlusal hypofunction on the elastic property and bone formation of rat alveolar bone

The purpose of this study was to investigate the influence of occlusal hypofunction on the maintenance of the elastic property and alveolar bone formation using an occlusal hypofunction model. Analyses of the elastic property and bone formation of the alveolar bone were carried out by the compression test and the bone histomorphometry in the two directions (the tooth axis direction and the bucco-lingual direction). The compression test was done with the texturometer to analyse the springiness of bone specimens of the mandibular first molar. Bone histomorphometric analyses were evaluated using double labeled frontal section. Results showed that occlusal hypofunction significantly reduced the springiness and suppressed the alveolar bone formation in the bucco-lingual direction. These results suggested that occlusal function plays an important role in maintenance of the elastic property and bone formation of the alveolar bone.     

带蒂胸大肌肌皮瓣在晚期舌癌舌再造术中的应用

目的分析胸大肌肌皮瓣在晚期舌癌根治术中舌再造的应用效果.方法对33例有完整资料T3、T4晚期舌癌患者因舌大部分或舌根部广泛切除术后大面积缺损,用同侧带蒂胸大肌肌皮瓣进行舌再造,一期修复.结果本组病例中除1例肌皮瓣大部分坏死外,其余均愈合良好,能恢复较理想的吞咽功能及语言表达能力.结论胸大肌肌皮瓣血供丰富,血管走向恒定,组织量大,是晚期舌癌根治术后同期进行舌再造的较理想材料.     

PerioGlas/rhBMP-2用于兔下颌骨侧嵴扩增的初步实验评估

目的 探讨PerioGlas（bioaetive glass，BG）与重组人骨形成蛋白-2（recombinent human bone morphogenetic protein-2，rhBMP-2）在下颌骨侧嵴扩增的可行性。方法在免磨牙区唇侧骨皮质表面，球钻预备4～6个5mm的骨缺损，一侧骨皮质表面和骨缺损内放置BG／rhGBMP-2，另一侧作为空白对照。术后正常饮食，2、4、8周后大体观察、组织学检查和组织学测量。结果观测时间内所有植入体固住良好，没有炎性反应。下颌骨表面明显加厚。材料表面骨组织覆盖；组织学观察皮质骨表面和骨缺损内新骨形成，2周纤维组织分割BG颗粒，4周大量新生骨呈编织骨样结构，新骨与BG颗粒直接结合。8周部分BG颗粒已降解被新骨取代，并与植骨床骨皮质表面直接结合，极少量残留颗粒被新骨包围。rhBMP-2／BG的表面成骨作用比单一BG、rhBMP-2好，具有明显的骨诱导性和骨引导性。新骨形成百分比明显高于BG（P〈0．05）。临床操作性能佳，易于放置，有止血作用。结论rhBMP-2／13G可以用于下颌骨侧嵴扩增。     

术前放疗对游离皮瓣影响的实验研究

本实验选用成年新西兰白兔２４只作单侧兔耳术前放疗，剂量分别为７Ｇｙ×４（Ⅰ组）、９Ｇｙ×４（Ⅱ组）及１１Ｇｙ×４（Ⅲ组），放疗后３周行双侧耳背皮瓣游离移植术（左右换位）．术后观察皮瓣的变化及成活情况，并于术后不同时期作光镜及电镜组织学观察，并行血管铸型标本制作及扫描电镜下形态计量分析．结果显示：Ⅰ组的皮瓣成活率为７５％（６／８），Ⅱ组为６２．５％（５／８），Ⅲ组为３７．５％（３／８）．光镜显示成活皮瓣存在上皮、皮肤附件及皮下组织明显萎缩现象，电镜下核固缩、胶原纤维水肿、基底膜不完整等表现可持续至术后１年以后，血管铸型标本中发现Ⅲ组血管密度明显低于Ⅱ组     

The angular bone defect and its relationship to trauma from occlusion and downgrowth of subgingival plaque

Sixty-four sets of human teeth were collected with the aim of evaluating the role of trauma from occlusion in the etiology of destructive periodontal disease. Before the jaws were taken out, a careful bite analysis was carried out. After fixation of the jaws, impressions were taken and plaster of Paris models were made. Finally, a set of 14 radiographs were taken. On the basis of the "clinical" records postmortem, the study models and the radiographs, the jaws were sectioned. Only mesio-distal sections were included in the present analysis. The total number of interdental spaces examined was 106. The following observations were made: 1. Before any loss of periodontal fiber attachment has taken place, the configuration of the interdental septum is entirely dependent on the location of the cemento-enamel junction (CEJ) of the two neighboring teeth. The alveolar crest does not approach the apical border of the junctional epithelium closer than about 1 mm. Thus, if the CEJ is located at different levels on two neighboring teeth, the marginal termination of the interdental septum will be oblique, forming an acute angle with the "lowest" tooth. 2. Loss of periodontal fiber attachment could invariably be related to the apical growth of subgingival plaque, and downgrowth of plaque was always associated with an inflammatory process which involved lysis of the attachment fibers within a distance varying between 0.2 and 1.8 mm from the apical border of the plaque. Subsequently, the JE proliferated down to cover the denuded root surface. 3. Reduction in height of the alveolar crest could also be related to the downgrowth of plaque. The distance from plaque to bone was never found to be less than 0.5 mm and never more than 2.7 mm. The configuration of the interdental septum always seemed to be determined by the level of the plaque on the two neighboring tooth surfaces. Thus, if the plaque had reached the same level on both sides, the crest of the interdental septum assumed a horizontal outline; if plaque had proliferated down to different levels, the crest of the interdental septum was oblique and an angular defect hereby established. 4. In the present material no evidence was found to indicate that functional (traumatic) forces can act as a co-factor in the causation of angular defects. In fact, such defects were found equally often adjacent to "nontraumatized" as to "traumatized" teeth. 5. Infrabony pockets were invariably associated with downgrowth of subgingival plaque.     

骨髓基质细胞-牙根-珊瑚羟基磷灰石复合体体内再植的初步观察

目的:评价体外构建的骨髓基质细胞(BMSCs)、珊瑚-羟磷灰石支架(CHA)、牙根复合体植入体内后牙根周组织的再生情况。方法:体外分离纯化的狗BMSCs分别与牙根及CHA支架共培养形成复合体后植入体内生长,16周后取材,组织切片观察牙根周组织的再生情况。结果:实验组较对照组所不同的是:有更趋成熟、致密的牙槽骨生成;牙根与牙槽骨之间形成了清晰的软组织间隙———类牙周膜结构,主要由纤维组织、毛细血管组成。结论:BMSC-CHA-牙根复合物植入体内后有效促进牙周组织的再生;组织工程学方法促进牙周组织再生具有可行性。     

Abbe皮瓣在上唇鳞状细胞癌术后缺损修复中的应用

目的:观察Abbe皮瓣修复上唇鳞状细胞癌切除术后缺损的临床疗效。方法:对5例37~62岁患有上唇鳞状细胞癌的患者进行肿瘤根治性切除,术后形成的继发性上唇缺损选择Abbe皮瓣修复,并进行临床观察。结果:4例患者术后外形良好,功能正常。1例术后出现轻度小口畸形,对进食,语言功能影响不明显,患者不要求治疗。结论:对上唇缺损宽度小于上唇唇长1/2者,治疗选择Abbe皮瓣修复,不仅能恢复口唇特有的红,白唇结构,而且还能恢复其特有的解解剖,生理功能,符合唇缺损的美学修复要求。     

扩大的耳廓组织瓣游离移植修复鼻基底细胞癌术后缺损

目的:探讨应用扩大的耳廓复合组织瓣修复鼻部基底细胞癌扩大切除术后缺损创面的手术方法及适应证。方法:根据患者病理确诊后实施鼻部基底细胞癌扩大切除术,依据缺损范围,采用单侧或双侧扩大耳廓复合组织瓣游离移植进行修复。术中彻底切除癌组织,病理证实切缘(-),将耳廓复合组织瓣游离,楔形植入鼻部缺损区,适度加压包扎固定,术后2周拆线。结果:本组18例患者,均移植成功,外形满意。修复创面面积约2.0~2.5cm,随访患者3~6个月,移植初期创面组织高出鼻部周缘,后期均发生不同程度回缩,与周缘组织融合自然,外形基本满意。结论:通过病理学证实肿物性质,确保周缘阴性,形成扩大创面,选用扩大耳廓复合组织瓣游离移植修复,通过对移植组织块精细缝合和适度加压固定技术,使创面得以修复,外形自然,供区隐蔽。本术式是较理想修复鼻部较大创面的术式选择。     

预构皮瓣的研究与应用进展

Prefabricated flap is so named as the skin flap is prepared by prefabricating a circulation-rich skin flap by implanting a named blood vessel or a portion of fascia which is incorporated with rich bloo...