Shao Zhen, Liu Baolin, Liu Yanpu, Liu Wenge, Liu Rifeng, Peng Qinjian, Liu Ling
Department of Traumatic and Aesthetic Surgery, Huangsi Aesthetic Surgery Hospital, 9 Huangsi Street, Beijing 100011, People's Republic of China.
J Plast Reconstr Aesthet Surg. 2006;59(2):181-7. doi: 10.1016/j.bjps.2005.04.032.
The potential use of distraction osteogenesis in mandibular reconstruction has been limited by its questionable efficacy in previously radiated bone. The purpose of this study was to evaluate the effects of irradiation on mandibular distraction osteogenesis (DO).
Six rabbits received a unilateral irradiation (group R) in the mandible with a total dose of 27.0 Gy in five 5.4 Gy fractions (equivalent to 50 Gy/25 fractions). The contralateral side served as control (group C). Bilateral osteotomy was made 3 months after completion of irradiation. After a 1-week latency period bone distraction was activated at a rate of 0.5 mm twice daily for 8 days, followed by a consolidation phase of 6 weeks. New bone underwent radiographic, densitometric, histological and histomorphometric analysis.
Two rabbits were excluded from the study, one due to infection on both sides and death in another animal. After 6 weeks of consolidation, the irradiation group had no significantly lower BMD than control group. No difference was found between the percent area of new bone in both groups. New bone was more mature and organised of group C than in groups R. Larger chondroid islands were found evident in distracted bone of group R than group C.
It seems that DO can be feasible in previously irradiated rabbit mandible.
牵张成骨在颌骨重建中的潜在应用受到其在先前接受过放射治疗的骨组织中疗效存疑的限制。本研究的目的是评估放射对下颌骨牵张成骨（DO）的影响。
6只兔子接受下颌骨单侧放射治疗（R组），总剂量为27.0 Gy，分5次给予，每次5.4 Gy（相当于50 Gy/25次）。对侧作为对照（C组）。放射治疗结束3个月后进行双侧截骨术。经过1周的延迟期后，以每天2次、每次0.5 mm的速率激活骨牵张，持续8天，随后是6周的巩固期。对新生骨进行放射学、骨密度测定、组织学和组织形态计量学分析。
2只兔子被排除在研究之外，1只因双侧感染，另1只死亡。巩固6周后，放射治疗组的骨密度显著低于对照组。两组新生骨面积百分比无差异。C组新生骨比R组更成熟、更有序。R组牵张骨中可见比C组更大的软骨样岛。
在先前接受过放射治疗的兔下颌骨中，牵张成骨似乎是可行的。
