骨形成蛋白聚乳酸复合物对人工腭裂上颌骨发育的影响

目的:探讨影响腭裂患者颌面部生长发育的先天因素,探讨腭裂手术中,骨形成蛋白复合物人工骨的移植对颌骨发育的影响。方法:以实验大白鼠为对象,制作腭部中缝处骨质缺损模型,以生物吸收降解材料聚乳酸作为载体、重组人骨形成蛋白-2作为骨形成材料复合移值,观察大白鼠头颅三维方向生长及局部组织学情况。结果:①在B组腭中缝处可见散在、不规则点、片状新生骨的阻射影;②重组人骨形成蛋白—聚乳酸复合物植入组(B)术后4周时,可见新生软骨生成量增加、成板层状。③统计学检验B组与C组差异无统计学意义,C组与N组、B组与N组比较差异有统计学意义。结论:①失去鼻中隔软骨对上颌骨生物性牵制推动力,以及失去腭中缝处向外横向扩张的软骨成骨能力,是导致腭裂(除外软腭裂)时上颌骨发育不良的内在重要因素。②腭裂手术中,人工骨的移植只能部分对抗中缝处无骨性结构带来的颌周软组织对上颌骨弓的向中线挤压作用,但不能完全阻抑上颌骨在腭裂时先天性、内在发育障碍。

The effect of BMP-2/PLA on maxillary growth and development of artificial cleft palate

Objective In order to test and verify the scar′s negative effect for the denuded palatal bone areas,discuss the role of the implantation after palate surgery using PLA and rhBMP in maxillary growth and development,find an efficient method to reduce the scar′s negative effects for the denuded palatal bone areas and to prevent the postoporation maxillary dysplasa.Method Wistar mouse was designed as palatal mucoperiosteum defects model.Recombinant human bone morphogenetic protein-2(rhBMP-2) as a material to regenerate bone,and biodegradable material PLA as a carrier,were implanted in the defects areas.The postoperation craniofacial 3-dimensional development and local histologic varieties were measured.Results Radiographs studies showed: The length of every experimental group was lower than the normal samples(N),and had significant difference(P<0.05), and had not significant difference than experimental contrastive group(C).Histology studies showed: The sharpey′s fibers embedded in the palatal bone were decreased that covered rhBMP/PLA and PLA(B,P).There was bone regeneration in the group implanted rhBMP/PLA(B).Conclusion Scar tissue covering the denuded bone restricts the maxillary sagittal and transverse growth.RhBMP/PLA can prevent sharpey′s fibers from embedding the palatal bone,alleviate the restriction of palatal bone initiated by scar tissues.PLA can be used as a carrier and it can also prevent sharpey′s fibers from embedding the palatal bone.