非血管化輸送盤牽張成骨的骨代謝研究
發(fā)布時間：2018-09-18 06:37
【摘要】：目的：復(fù)制非血管化輸送盤牽張成骨修復(fù)下頜骨缺損的動物模型,通過骨代謝的研究,探討該成骨模式的成骨機(jī)理和輸送盤的轉(zhuǎn)歸,為臨床應(yīng)用提供實(shí)驗(yàn)依據(jù)。 方法：將8只成年雜種犬隨機(jī)分成牽張后固定2周、4周、8周和14周共四組,每組2只,術(shù)中在犬右側(cè)下頜骨下緣制備長約10.0mm×高約10.0mm部分頜骨缺損模型,于缺損遠(yuǎn)中制備長約20.0mm×高約10.0mm非血管化輸送盤并安裝內(nèi)置式牽張器,5天后開始以1.0mm/天／次速度向近中連續(xù)牽張以修復(fù)缺損。牽張結(jié)束按固定期分別處死動物并制取標(biāo)本,分別進(jìn)行大體觀、掃描電鏡觀察和X線能譜儀檢測。 結(jié)果：1.大體標(biāo)本實(shí)驗(yàn)對象均完成牽張成骨的過程,傷口愈合良好,狗下頜骨缺損成功修復(fù)。從2周開始可見隨著固定時間的增長,輸送盤周圍新骨從舌側(cè)向頰側(cè)包繞生長,輸送盤逐漸縮小最終輸送盤被周圍新骨完全替代,不能辨別界限；牽張區(qū)內(nèi)也隨固定時間的增長新骨不斷增厚,到14周下頜骨已恢復(fù)連續(xù)性。2.掃描電鏡牽張區(qū)內(nèi)2周即有新骨生成,且大量的膠原纖維沿著牽張方向生長,隨著固定時間的延長,鈣鹽顆粒不斷沿膠原纖維排列方向沉積,新骨不斷成熟,14周時已經(jīng)形成含成熟哈弗氏系統(tǒng)的板層骨。3.X線能譜儀牽張區(qū)新骨從2周開始牽張區(qū)新骨鈣化程度逐漸向正常骨組織靠近,14周時,接近正常骨組織鈣化程度的85%。輸送盤周圍新骨從2周開始鈣化程度逐漸向正常骨組織靠近,從建模到4周為輸送盤周圍新骨鈣化最快的時期,且新骨是先從舌側(cè)貼近骨膜側(cè)開始鈣化的。 結(jié)論：我們成功的復(fù)制了非血管化輸送盤牽張成骨修復(fù)狗下頜骨的模型,剝離骨膜的輸送盤可以同樣獲得牽張區(qū)內(nèi)高質(zhì)量的成骨,加入牽張因素的游離骨移植仍可通過爬行替代被新骨取代,即整個非血管化輸送盤牽張成骨的修復(fù)過程是以牽張成骨為主并伴有爬行替代的共同作用結(jié)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.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2011
【分類號】：R782;R-332
本文編號：2247084
[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.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2011
【分類號】：R782;R-332
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