非血管化游离骨移植同期种植骨活力的实验研究

目的观察非血管化骨移植同期种植的骨块在不同离体时间点植入体内后细胞活力及成骨情况.方法拔除狗前磨牙,口腔粘膜完全愈合后,截除长度3 cm的无牙下颌骨段,取不带血管和软组织的髂骨全层,植入直径2 mm带自攻螺纹的纯钛种植体2～3枚,分别在离体60、120分钟内植入下颌缺损区.术后4、8周取出植骨块,观察游离移植的非血管化骨块内细胞活力和新骨形成情况.结果非血管化游离骨移植同期种植恢复了下颌骨节段性缺损的连续性.游离骨块在离体60分钟植入体内4～8周为活骨块,可见到大量成活的骨细胞,并有数量不等的新骨形成.离体120分钟的游离骨块植入体内后4～8周为死骨块,其中未见成活骨细胞,部分骨块中见到破骨细胞.结论在以狗为对象的实验中,非血管化游离髂骨块移植同期种植可以修复长度3cm的下颌骨节段性缺损,植入体内骨块能否成活与其离体时间有关.

An experimental study on survival ability of non-vascularized graft and coinstantaneous implantation in canine mandible defects reconstruction

Objective To observe osteocyte survival and osteogenesis of non-vascularized free bone graft and coinstantaneous dental implantation in canine mandible mass defect reconstruction.Methods Canine premolar was extracted before the 3 cm long edentulous mandible was cut off. The non-vascularized ilium block was cut off and fixed into mandible defect with 2-3 dental implants 60 and 120 minutes after the graft was harvested. The survival osteocyte and osteogenesis of the non-vascularized graft were detected afer 4-8 weeks.Results The continuity of canine mandible mass defect was repaired by free non-vascularized graft, and live osteocytes and osteogenesis were observed in non-vascularized graft at off-body 60 minutes group at 4-8 weeks. But the non-vascularized free bone graft of off-body 120 minutes was dead, and no survival osteocytes were observed, some osteoclasts were seen in the bone graft.Conclusion The mandible defect can be restored by non-vascularized free bone graft and coinstantaneous dental implantation. The osteocyte survival and osteogenesis are related to their off-body time before they are fixed into recipient.