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论文摘要

腭裂缘骨膜牵张成骨不同阶段的组织学变化分析

The histological analyse about repairing cleft palate through osteogenesis by periosteal distraction

作者:宋庆高 邓金勇 陈尚 黄桂林 蒋练

Author:SONG Qing-gao, DENG Jin-yong, CHEN Shang, HUANG Gui-lin, JIANG Lian.

收稿日期:2010-05-27          年卷(期)页码:2011,38(2):141-144

期刊名称:国际口腔医学杂志

Journal Name:International Journal of Stomatology

关键字:腭裂, 骨膜牵张成骨, 腭裂整复术, 组织学,

Key words:cleft palate, periosteal distraction ostegenesis, palatoplasty, histology,

基金项目:

贵州省省长基金资助项目(2005245);贵州省科技攻关基金资助项目(2004NGY039)

中文摘要

目的对腭裂裂隙缘的骨膜进行牵张,研究新骨形成的过程及规律,初步探讨骨膜牵张成骨方法修复腭裂的机制。方法选用健康杂种幼犬8只制作腭裂动物模型,采用安置骨膜牵张器的方法对裂隙缘的一侧骨膜进行牵张,牵张力为(2.45±0.20)N。在牵张器放置后20、30、40、60 d 各处死动物2 只,未放置一侧为对照侧。结果裂隙缘骨膜受牵张后,新生成骨细胞数量随时间变化而增多,大量沿牵张方向排列的胶原纤维组织在增生的成骨细胞作用下,钙化沉积成新骨,并逐渐改建成熟。结论新骨形成是沿牵张方向的膜内成骨方式完成的,在骨膜牵张器放置20 d后牵张区已有新骨形成,随着牵张时间的延长,成骨量逐渐增加,40 d 时的成骨活动最活跃,至60 d时新骨钙化程度较成熟,以骨改建和塑形为主。

英文摘要

Objective Based on a periosteal distraction to periosteum of cleft palate edge, to observe the structural features of newly formed bone in each phase, study its forming process and rule, and make a preliminary study on the mechanism of repairing cleft palate. Methods Firstly, develop model of cleft palate in 8 healthy hybrid juvenile dogs. Then place Nitinol periosteal distraction device under the periosteum of cleft palate edge and fix it and distract the periosteum with a force of(2.45±0.20)N. The opposite edge belongs to control group. Every 2 dogs were killed after 20, 30, 40, 60 days respectively. Results New bone eventually generated under the periosteum after the periosteal distraction at the edge of cleft. Histological observation indicates the increase of osteoblasts in the new bone and the changes of the directions of the collagenous fiber and bone trabecula. A large amount of collagenous fibers arrayed toward the direction of distraction, under the influence of proliferation of osteoblasts, was calcified and become new bone, which gradually became more mature. Conclusion Newly formed bone is completed along the distracting direction in the periosteum. New bone generates in the distraction zone 20 days after the implantation of periosteal distraction device. With the time of placement extending, bone grows, which is most vigorous on the 40th day and becomes relatively mature in terms of calcification on the 60th day focusing on transformation and modeling.

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