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。

Suture expansion osteogenesis for closing the posterior hard palate:An experimental study in dogs \

Objective\ This study investigated the possibility of a new approach,e.g.suture expansion osteogenesis for closing the posterior hard palate.By this technique we might hope to replace missing tissue in the clefts by tissue regeneration and achieve bony repair in the posterior hard palate and circumvent the problems of speech and facial growth seen in traditional cleft surgery. Methods\ Nine 8month mongrel dogs were divided into three groups:the control(n=1),sham control(n=2)and the experimental group(n=6).In six experimental dogs,an 8 mm wide cleft was made surgically.Suture expansion devices made of NiTishape memory alloy with force levels of 200g,360g and 480g were secured in the palatine bones to expand the lateral sutures of the palatine bones.Clinical and histological examinations were performed to observe the changes.THZ]Results\ The clefts in the experimental group were closed completely sooner or later within a period from 5 to 14 days.While the clefts in the sham group became a little larger than their original size.There was significant new bone formation at the edge of the expanded suture. Conclusion\ The clefts in young dogs could be closed by the technique of suture expansion.The NiTiSMA expander used in the study was consistently effective and all the force levels could induce a great amount of new bone formation with the trabeculae being thinner and longer by heavy forces.\