Duran Ismet, Malkoç Siddik, Işeri Haluk, Tunali Mustafa, Tosun Murat, Küçükkolbaşi Hasan
Periodontology Department, Faculty of Dentistry, Selçuk University, Konya 42079, Turkey.
Angle Orthod. 2006 May;76(3):369-74. doi: 10.1043/0003-3219(2006)076[0369:MEOMSD]2.0.CO;2.
The purpose of this study was to evaluate microscopically the newly formed hard tissue after a consolidation period of mandibular symphyseal distraction osteogenesis (MSDO). Sixteen patients underwent MSDO treatment. After a latency period of seven days, the distraction device was activated by the patient once in the morning and once in the evening, for a total of one mm per day for a mean 10.1 +/- 2.8 days, and the mean opening of the device was 8.1 +/- 1.7 mm. The device was usually maintained in position approximately 90 days after surgery. After the completion of the distraction period, the lower anterior teeth were bonded and tooth movement into the distraction site was initiated. After a consolidation period, second surgery was performed to remove the distraction devices. During the second surgery, hard tissue biopsies were taken on the apical region of the two central incisors and the left canine. The samples were fixed in 10% buffered formalin and decalcified in 3% HNO(3) solutions. New bone formation was present within the distraction gap immediately after the consolidation period. The cellular construction was more irregular in the distraction sections than in the normal bone sections. The newly distracted area was not complete immediately after the consolidation period. Furthermore, the newly formed bone had a membranous structure, which indicates continual maturation. Bone exposed to stretching forces undergoes new bone formation, and the newly formed bone is of a membranous type also named as a woven type.
本研究的目的是通过显微镜评估下颌骨联合部牵张成骨术（MSDO）巩固期后新形成的硬组织。16例患者接受了MSDO治疗。经过7天的潜伏期后，患者每天早晚各激活一次牵张装置，每天总共牵张1毫米，平均牵张10.1±2.8天，装置的平均张开度为8.1±1.7毫米。通常在术后约90天保持装置在位。牵张期结束后，粘结下前牙并开始将牙齿向牵张部位移动。经过巩固期后，进行第二次手术以取出牵张装置。在第二次手术期间，在两颗中切牙和左侧尖牙的根尖区域进行硬组织活检。样本固定于10%缓冲福尔马林中，并在3%硝酸溶液中脱钙。巩固期结束后，牵张间隙内立即出现新骨形成。牵张部位切片中的细胞结构比正常骨切片中的更不规则。巩固期结束后，新牵张区域并未立即完全形成。此外，新形成的骨具有膜性结构，这表明其仍在持续成熟。受到拉伸力作用的骨会经历新骨形成，新形成的骨为膜性类型，也称为编织型。
