Conejero J Alejandro, Lee James A, Ascherman Jeffrey A
Department of Surgery, Division of Plastic Surgery, at the Columbia University Medical Center, New York, New York 10032, USA.
J Craniofac Surg. 2007 Nov;18(6):1290-5. doi: 10.1097/scs.0b013e3180f610c7.
The purpose of this study was to investigate bone healing in a rabbit cranial defect model using different mixtures of bioglass (NovaBone C/M; Porex Surgical, Inc., Newnan, GA) and autologous bone with and without an overlying absorbable plate (Lactosorb; Walter Lorenz Surgical, Jacksonville, FL). Twelve rabbits were divided into three groups, and a 2 cm diameter cranial defect was created in each rabbit. Group I defects were filled with 80% bioglass and 20% autologous bone, group II with 60% bioglass and 40% autologous bone, and group III with 60% bioglass and 40% autologous bone with the addition of an absorbable plate placed directly over the reconstructed defect to help separate it from the overlying soft tissues. Rabbits were euthanized 6 months postoperatively. Histologic examination was then performed. The size of the remaining bone gap, area of reossification within the defect, and percentage of fibrous tissue within the defect were measured. Histologic analyses revealed that group II animals had an increased cross-sectional area of bone formation and decreased bone gap when compared with group I and III animals (P < 0.05). There were no statistical differences between groups I and III with regard to bone formation. This study suggests that when combining bioactive glass and autologous bone for repairing cranial defects, a combination of 60% bioactive glass and 40% bone graft yields superior results to a combination of 80% bioactive glass and 20% bone graft. Placing an absorbable plate over a defect filled with 60% bioactive glass and 40% bone graft inhibits rather than promotes reossification.
本研究的目的是在兔颅骨缺损模型中，研究使用不同比例的生物玻璃（NovaBone C/M；Porex Surgical公司，佐治亚州纽南市）与自体骨混合，以及在有或没有覆盖可吸收板（Lactosorb；Walter Lorenz Surgical公司，佛罗里达州杰克逊维尔市）的情况下的骨愈合情况。将12只兔子分为三组，每组兔子均制造一个直径2厘米的颅骨缺损。第一组缺损填充80%的生物玻璃和20%的自体骨，第二组填充60%的生物玻璃和40%的自体骨，第三组填充60%的生物玻璃和40%的自体骨，并在重建的缺损上方直接放置一块可吸收板，以帮助其与上方的软组织分离。术后6个月对兔子实施安乐死。然后进行组织学检查。测量剩余骨间隙的大小、缺损内再骨化的面积以及缺损内纤维组织的百分比。组织学分析显示，与第一组和第三组动物相比，第二组动物的骨形成横截面积增加，骨间隙减小（P<0.05）。第一组和第三组在骨形成方面无统计学差异。本研究表明，当将生物活性玻璃与自体骨联合用于修复颅骨缺损时，60%生物活性玻璃与40%骨移植的组合比80%生物活性玻璃与20%骨移植的组合产生更好的效果。在填充60%生物活性玻璃和40%骨移植的缺损上方放置可吸收板会抑制而非促进再骨化。
