华西口腔医学杂志

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牵张成骨矫治腭裂新骨生成区超微结构特征的研究

陈刚,王大章,刘宝林,李唐新,廖运茂,胡静,郑光勇   

  1. 710032 第四军医大学口腔医学院(陈 刚,刘宝林,陈 刚曾为华西医科大学博士研究生),四川大学华西口腔医学院(王大章,李唐新,廖运茂,胡 静,郑光勇)
  • 收稿日期:2002-06-25 修回日期:2002-06-25 出版日期:2002-06-20 发布日期:2002-06-20
  • 基金资助:
    本课题为四川省重点科学技术研究资助项目(编号G9906)

Distraction Osteogenesis for the Repair of Cleft Palate----An Ultrastructural Study

Chen Gang, Liu Baolin, Wang Dazhang et al   

  1. West China College of Stomatology, Sichuan University
  • Received:2002-06-25 Revised:2002-06-25 Online:2002-06-20 Published:2002-06-20

摘要:

目的:观察不同时间间期牵张生成的新骨组织的超微结构特征,探讨新骨生成的规律。方法:建立12只动物的人工腭裂实验模型,实验组动物10只:应用牵张成骨术,以每日2次,每次014 mm的速度和恒定的方向整复其腭部软硬组织缺损,至裂隙完全封闭。于术后固定期第2、4、6、8及12周分别安乐处死2只实验动物,切取标本后于扫描电镜下观察,并与实验对照组及空白对照组(动物各2只)观察结果对比。结果:第2周时,牵张区以大量沿牵张方向排列的胶原纤维束为主,成纤维细胞大量增殖,新生骨小梁钙化程度低。第4~6周时,成骨活动极其活跃,骨小梁较致密,其表面密集排列成骨细胞。新骨呈/蜂巢样0结构。第8~12周时,骨小梁结构逐渐钙化成熟。实验对照组裂隙创缘处无明显新骨形成。结论:应用牵张成骨术矫治腭裂骨质缺损,以原位产生新骨,增加骨量的方式推移骨运送盘封闭腭裂裂隙。术后早期即有膜内成骨的新骨形成,并最终改建成熟为适应正常生理功能需要的骨质结构。

关键词: 牵张成骨, 腭裂, 动物模型, 超微结构

Abstract:

Objective:The aim of this study was to explore ultrastructural characters of the newly formed bone in the correction of cleft palate (CP) bone defect by distraction osteogenesis (DO).Methods:The CP experimental animal models (12 cats) were estab- lished surgically, and were divided randomly into the experimental group (10 cats), in which the hard palate bone defects were corrected with DO procedure at the rate of 0.4 mm@2/day. The specimen retrieval with euthanasia was carried out at 2, 4, 6, 8, 12 weeks after completion of distraction. Ultrastructural study was then performed; the experimental control group (2 cats) was kept for 6 weeks before euthanasia without any correction, the other extra 2 cats were used as the negative control.Results:New bone formation appeared in early 2 weeks. Exclusively intramembranous bone formation was observed in all specimens. The re- modeling activities were keep observed throughout the period of study, and the bone structure matured gradually till 12 weeks after the completion of DO. No repairwas observed in experimental control group.Conclusion:The reconstruction of CP bone defectby means of DO could get active intramembranous bone formation and remodeling, which adapted to normal functional activities.

Key words: distractionosteogenesis, cleftlip/palate, animalmodel, ultrastructure