Hu J, Tang Z, Wang D, Buckley M J
Department of Oral and Maxillofacial Surgery, Sichuan University, Chengdu, Sichuan, China.
J Oral Maxillofac Surg. 2001 Sep;59(9):1041-5; discussion 1046. doi: 10.1053/joms.2001.25849.
This study investigated the changes in the inferior alveolar nerve after mandibular lengthening with different rates of distraction.
Bilateral mandibular corticotomies were performed in 8 goats. The mandibles in 6 goats were lengthened 10 mm using a custom-made distractor with 2 different rates of distraction (1 mm/d [n = 3] and 2 mm/d [n = 3]); the other 2 nondistracted mandibles served as a control. The goats with distracted mandibles were killed at 2 weeks after completion of distraction. The inferior alveolar nerve specimens from all animals were harvested and processed for histologic and ultrastructural evaluation.
The mandibles were lengthened successfully in the distracted animals. Morphologic changes in the inferior alveolar nerves were observed when compared with the nondistracted controls. Moreover, signs of nerve degeneration, such as demyelination, axonal swelling, axoplasmic darking, and decrease in the number of axons, were more extensive and prominent in those nerves distracted at a rate of 2 mm/d.
Degenerative changes in the inferior alveolar nerve occur after mandibular lengthening by distraction osteogenesis. The distraction rate of 1 mm/d appears to be tolerable and safe for the inferior alveolar nerve, but rapid distraction may cause serious degeneration.
本研究调查了不同牵张速率下颌骨延长术后下牙槽神经的变化。
对8只山羊行双侧下颌骨皮质切开术。6只山羊的下颌骨使用定制牵张器延长10 mm,牵张速率分为2种(1 mm/d [n = 3]和2 mm/d [n = 3]);另外2只未牵张的下颌骨作为对照。牵张下颌骨的山羊在牵张完成后2周处死。采集所有动物的下牙槽神经标本,进行组织学和超微结构评估。
牵张组动物下颌骨成功延长。与未牵张的对照组相比,下牙槽神经出现形态学改变。此外,神经退变迹象,如脱髓鞘、轴突肿胀、轴浆增深和轴突数量减少,在牵张速率为2 mm/d的神经中更为广泛和明显。
牵张成骨下颌骨延长术后下牙槽神经会发生退行性改变。1 mm/d的牵张速率对下牙槽神经似乎是可耐受且安全的,但快速牵张可能导致严重退变。