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牵张成骨:正畸牙齿移动对牵张下颌骨的影响。

Distraction osteogenesis: the effects of orthodontic tooth movement on distracted mandibular bone.

作者信息

Liou E J, Polley J W, Figueroa A A

机构信息

Hektoen Institute, Department of Surgery, Cook County Hospital, Chicago, Illinois, USA.

出版信息

J Craniofac Surg. 1998 Nov;9(6):564-71.

Abstract

The application of distraction osteogenesis in craniomaxillofacial surgery has created new treatment methods for patients with craniofacial skeletal dysplasias. Most of the applications in the craniofacial skeleton have been for the correction of severe congenital or acquired conditions. As more understanding is gained with these new approaches, refinements in techniques will enhance treatment planning and outcome. This will expand the application of distraction osteogenesis to more common, less severe types of skeletal dysplasias. One of the important areas in mandibular distraction osteogenesis is the management of the dental gap created when distraction is applied within the tooth-bearing segment of the mandibular body. In this study, the authors investigated the effects of orthodontic tooth movement into new bone created through the process of distraction osteogenesis. Orthodontic tooth movement through newly formed mandibular bone in the canine model was performed and, through histologic studies, was found to create compact bone along the path of the moving tooth. This compact bone replaced the more unstructured woven bone that was originally created by the process of mandibular distraction osteogenesis. These findings indicate that orthodontic tooth movement can be performed in distracted bone and can have significant influence on the stability and long-term structural preservation of the bone created by distraction osteogenesis within the tooth-bearing segment of the mandible.

摘要

牵引成骨技术在颅颌面外科的应用为颅面骨骼发育异常的患者创造了新的治疗方法。颅面骨骼的大多数应用都是用于矫正严重的先天性或后天性疾病。随着对这些新方法的了解越来越多,技术的改进将提高治疗计划和治疗效果。这将把牵引成骨技术的应用扩展到更常见、不太严重的骨骼发育异常类型。下颌骨牵引成骨的一个重要领域是在下颌体牙列段进行牵引时所产生牙间隙的处理。在本研究中,作者研究了正畸牙齿移动到通过牵引成骨过程形成的新骨中的效果。在犬模型中对穿过新形成的下颌骨进行正畸牙齿移动,并通过组织学研究发现,在移动牙齿的路径上会形成致密骨。这种致密骨取代了最初由下颌骨牵引成骨过程产生的结构更松散的编织骨。这些发现表明,正畸牙齿移动可以在牵引后的骨中进行,并且对下颌骨牙列段牵引成骨所形成的骨的稳定性和长期结构保存有重大影响。

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