摘要
目的对比天然珊瑚石和珊瑚羟基磷灰石2种人工骨材料夹心法对下颌骨厚度扩展中成骨的影响。方法中国实验用山羊9只,12~16个月龄,体质量15~20 kg,行双侧下颌骨外板截骨术后,采用简单随机方法在双侧下颌骨分别夹心置入天然珊瑚石和珊瑚羟基磷灰石。在术后6、12、18个月3个时间点取材,每次3只山羊,分别取天然珊瑚石人工骨、珊瑚羟基磷灰石置入区2 cm大小骨质标本,行组织学检查(HE、甲苯胺蓝染色)、扫描电镜检测,观察下颌骨成骨情况。结果3个时间点观察下颌骨术区均已骨性愈合,钛板、钛钉大部分或者全部被骨组织包埋。HE染色和甲苯胺蓝染色显示,术后6个月天然珊瑚石侧骨化程度明显优于珊瑚羟基磷灰石侧,天然珊瑚石已经完全降解;术后12~18个月珊瑚羟基磷灰石侧成骨明显增强,成熟程度也较术后6个月时更高,珊瑚羟基磷灰石在术后18个月完全降解。扫描电镜发现,术后6个月天然珊瑚石侧成骨较珊瑚羟基磷灰石侧明显,术后12~18个月两侧成骨无明显差别。结论天然珊瑚石和珊瑚羟基磷灰石夹心法在下颌骨厚度扩展中成骨明显,夹心法是一种下颌骨厚度发育不良矫治的简单可行方法,为下颌骨厚度的扩展提供了新的思路。
Objective To investigate the influence on osteogenesis during mandibular augmentation with a new sandwichosteotomy with interpositional natural coral and coralline hydroxyapatite(CHA).Methods Nine goats were randomly divided into three groups and observed at 6 months,12months and 18 months after surgery.All goats received splitting of bilateralmandibular outer cortex and interpositional grafting with natural coral and corallinehydroxyapatite respectively(sandwich osteotomy).Partial mandible in each group had been harvested to do histology examination(HE staining and Toluidine blue staining)and ultrastructure analyses(Scanning electron microscope,SEM).Results All subjects were evaluated atdifferent time points.Both natural coral and coralline hydroxyapatite side healed at three groups.Natural coral were degraded at about 6 months postoperation,coralline hydroxyapatite at about 12 months.The results of HE staining,Toluidine blue staining and SEM revealed that natural coral side had better osteogenesis than coralline hydroxyapatite side at 6 months after operation.However,Natural coral and coralline hydroxyapatite side had no significant differences at 12 and 18months.Conclusions This study suggests an alternative method for mandibular augmentation witha sandwich osteotomy and interpositional grafting with natural coral and CHA.Bothcoral hydroxyapatite and natural coral have good osteogenesic effect for mandibular augmentation.
作者
谭骛远
陈莹
王梦
刘剑锋
牛峰
俞冰
归来
Tan Wuyuan;Chen Ying;Wang Meng;Liu Jianfeng;Niu Feng;Yu Bing;Gui Lai(Department of Plastic and Aesthetic Surgery,Xiangya Hospital,Central South University,Changsha 410008,China;Department of Craniomaxillofacial Surgery,Plastic Surgery Hospital,Chinese Academy of Medical Science,Peking Union Medical College,Beijing 100144,China)
出处
《中华整形外科杂志》
CAS
CSCD
北大核心
2020年第4期447-452,共6页
Chinese Journal of Plastic Surgery
关键词
夹心法
天然珊瑚
珊瑚羟基磷灰石
成骨
Sandwich osteotomy
natural coral
Coralline hydroxyapatite
Osteogenesis
