Al-Qareer Athbi H A, Afsah Mohammed R, Müller Hans-Peter
Faculty of Dentistry, Kuwait University, Safat, and Central State Slaughterhouse, Shuwaikh, Kuwait.
Eur J Dent Educ. 2004 May;8(2):78-83. doi: 10.1111/j.1600-0579.2003.00334.x.
There is lack of data on the suitability of animal cadaver models for teaching purposes in dentistry. Here, we describe a model suitable for training for several periodontal surgical methods. Mandibles of freshly slaughtered Australian adult sheep and lambs were examined. Periodontal probing depths (PPDs) were measured at six sites of every tooth present. The following surgical techniques were critically analyzed: access flap with interrupted, continuous sutures; apically repositioned flap with periosteal sutures; coronally advanced flap with sling suture; gingivectomy; and distal wedge procedure. Probing depths were highest in the buccal furcation area of 1st and 2nd molars, where deep intrabony lesions were present in certain samples from adult sheep. Another area of increased probing depth was lingual to canines and incisors. Here, a pronounced lower dental pad of fibrous tissue was present. In this area, gingivectomy could always be accomplished. Fibrous tissue was also found distal to the most posterior molar, where the distal wedge procedure could be exercised. Access flaps and apically repositioned flaps could be performed particularly at premolars. Here, interrupted or continuous sutures were possible. Because of tight interdental contact areas, needle insertion was difficult at molars. After periosteal dissection, labial flaps at anterior teeth could easily be advanced coronally and sutured with sling sutures. Because of the teeth's dimensions and tight contact areas, simulation of more advanced techniques such as papilla preservation flaps was not possible. The sheep mandible seems to be a feasible training model for the demonstration and exercise of various periodontal surgical techniques for the treatment of periodontitis.
关于动物尸体模型在牙科教学适用性方面的数据匮乏。在此，我们描述一种适用于多种牙周手术方法训练的模型。对刚屠宰的澳大利亚成年绵羊和羔羊的下颌骨进行了检查。测量了每颗现存牙齿六个位点的牙周探诊深度（PPD）。对以下手术技术进行了严格分析：间断、连续缝合的翻瓣术；骨膜缝合的根向复位瓣术；悬吊缝合的冠向推进瓣术；牙龈切除术；以及远中楔形切除术。在第一和第二磨牙的颊侧根分叉区探诊深度最高，成年绵羊的某些样本中存在深部骨内病变。另一个探诊深度增加的区域是犬齿和切牙的舌侧。此处存在明显的纤维组织下牙垫。在这个区域，牙龈切除术总能成功完成。在最后一颗磨牙远中也发现了纤维组织，在此处可进行远中楔形切除术。翻瓣术和根向复位瓣术尤其可在前磨牙处进行。此处可采用间断或连续缝合。由于牙间隙接触区域紧密，在磨牙处进针困难。骨膜剥离后，前牙的唇侧瓣可轻松向冠方推进并用悬吊缝合法缝合。由于牙齿尺寸和紧密的接触区域，无法模拟更先进的技术，如乳头保留瓣术。绵羊下颌骨似乎是用于演示和练习各种治疗牙周炎的牙周手术技术的可行训练模型。
