非血管化输送盘牵张成骨的骨代谢研究

发布时间：2018-09-18 06:37

【摘要】：目的：复制非血管化输送盘牵张成骨修复下颌骨缺损的动物模型,通过骨代谢的研究,探讨该成骨模式的成骨机理和输送盘的转归,为临床应用提供实验依据。方法：将8只成年杂种犬随机分成牵张后固定2周、4周、8周和14周共四组,每组2只,术中在犬右侧下颌骨下缘制备长约10.0mm×高约10.0mm部分颌骨缺损模型,于缺损远中制备长约20.0mm×高约10.0mm非血管化输送盘并安装内置式牵张器,5天后开始以1.0mm/天／次速度向近中连续牵张以修复缺损。牵张结束按固定期分别处死动物并制取标本,分别进行大体观、扫描电镜观察和X线能谱仪检测。结果：1.大体标本实验对象均完成牵张成骨的过程,伤口愈合良好,狗下颌骨缺损成功修复。从2周开始可见随着固定时间的增长,输送盘周围新骨从舌侧向颊侧包绕生长,输送盘逐渐缩小最终输送盘被周围新骨完全替代,不能辨别界限；牵张区内也随固定时间的增长新骨不断增厚,到14周下颌骨已恢复连续性。2.扫描电镜牵张区内2周即有新骨生成,且大量的胶原纤维沿着牵张方向生长,随着固定时间的延长,钙盐颗粒不断沿胶原纤维排列方向沉积,新骨不断成熟,14周时已经形成含成熟哈弗氏系统的板层骨。3.X线能谱仪牵张区新骨从2周开始牵张区新骨钙化程度逐渐向正常骨组织靠近,14周时,接近正常骨组织钙化程度的85%。输送盘周围新骨从2周开始钙化程度逐渐向正常骨组织靠近,从建模到4周为输送盘周围新骨钙化最快的时期,且新骨是先从舌侧贴近骨膜侧开始钙化的。结论：我们成功的复制了非血管化输送盘牵张成骨修复狗下颌骨的模型,剥离骨膜的输送盘可以同样获得牵张区内高质量的成骨,加入牵张因素的游离骨移植仍可通过爬行替代被新骨取代,即整个非血管化输送盘牵张成骨的修复过程是以牵张成骨为主并伴有爬行替代的共同作用结果。
[Abstract]:Objective: to establish an animal model of distraction osteogenesis with non-vascularized transport disc to repair mandibular defect, and to explore the mechanism of osteogenesis and the outcome of transport disc through the study of bone metabolism, and to provide experimental basis for clinical application. Methods: eight adult mongrel dogs were randomly divided into four groups (2 in each group) after 2 weeks, 4 weeks and 14 weeks after distraction. The model of partial mandibular defect with 10.0mm 脳 high 10.0mm was made at the lower margin of the right mandible during the operation. A non-vascularized transport disc with a length of about 20.0mm 脳 high about 10.0mm was prepared at the distance of the defect and a built-in stretcher was installed for 5 days. After 5 days, the defect was repaired by continuous stretching at the speed of 1.0mm/ days / times. At the end of distraction, animals were killed according to the fixed period, and the specimens were made for gross observation, scanning electron microscopy (SEM) and X-ray energy spectrometer (EDS). The result is 1: 1. Distraction osteogenesis was completed in all subjects. The wound healed well and the mandibular defect was repaired successfully. From the beginning of 2 weeks, with the increase of fixed time, the new bone around the tray grew from the side of the tongue to the buccal side, and the tray gradually shrinked and was completely replaced by the surrounding new bone, which could not distinguish the boundary. In the distraction area, the new bone thickened with the increase of fixation time, and the mandibular bone recovered to the continuity of .2by 14 weeks. New bone was formed in the distraction zone of scanning electron microscope (SEM), and a large number of collagen fibers grew along the direction of distraction. With the prolongation of the fixed time, the calcium salt particles were deposited along the collagenous fibers. After 14 weeks of maturation, the lamellar bone containing the mature Hafer's system has been formed. 3. The new bone in the distraction zone of the new bone is gradually approaching to the normal bone tissue at 14 weeks, and is close to the normal bone calcification level at the beginning of 2 weeks, and is close to that of the normal bone tissue at the end of 14 weeks. The degree of calcification of the new bone around the tray began to approach to the normal bone tissue from 2 weeks to 4 weeks, and the calcification of the new bone began from the lingual side close to the periosteum side. Conclusion: we successfully duplicated the distraction osteogenesis model of canine mandible with non-vascularized transport disc, and the high quality osteogenesis in distraction zone could be obtained by removing periosteum transport disc. Free bone graft with distraction factor can still be replaced by new bone by crawling replacement, that is, the repair process of distraction osteogenesis of the whole non-vascularized transport disc is mainly the result of distraction osteogenesis and accompanied by creeping replacement.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R782;R-332

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