Department of Oral and Maxillofacial Surgery, West China College of Stomatology, Sichuan University, Chengdu, PR China.
Injury. 2009 Aug;40(8):831-4. doi: 10.1016/j.injury.2008.09.011. Epub 2009 Feb 12.
Distraction osteogenesis typically requires a long treatment period, which can lead to bone and soft-tissue infection and considerable patient discomfort. Use of a rapid distraction rate in craniofacial distraction osteogenesis to shorten the distraction period is possible owing to the unique characteristics of craniofacial bones, including an abundant blood supply and rapid bone healing compared with long bones. The effects of using a rapid distraction rate in the treatment of craniofacial deformities are currently unclear, however. The objective of this study was to investigate the effects of a rapid distraction rate on new bone formation during mandibular distraction osteogenesis in goats.
Sixteen goats were randomly divided into four groups consisting of four goats each. In Groups A, B, and C, the right mandible of each goat was distracted at a rate of 0.8mm/d, 1.6mm/d, and 2.0mm/d, respectively; Group D was the control group and did not undergo distraction. Six weeks after the conclusion of distraction, bone densitometry and three-point bending testing were performed in all groups.
The mean bone density value of goats in Group A was significantly higher than those of all the other groups (p<0.05), and the mean bone density value of goats in Group C was significantly lower than those of all the other groups (p<0.05). The mean curve slope, peak stress, bending modulus, and energy to failure values of Groups A, B, and C were all significantly lower than those of the control group (p<0.05). As the distraction rate increased, the curve slope and peak stress values gradually declined (p<0.05).
Use of a rapid distraction rate in mandibular distraction osteogenesis may have detrimental effects on the quality of new bone, despite the abundant blood supply of craniofacial bones.
牵张成骨术通常需要较长的治疗期，这可能导致骨和软组织感染以及患者相当大的不适。由于颅面骨与长骨相比具有丰富的血液供应和快速的骨愈合等独特特征，因此在颅面牵张成骨术中使用快速牵张率来缩短牵张期是可行的。然而，目前尚不清楚在颅面畸形治疗中使用快速牵张率的效果。本研究旨在探讨快速牵张率对山羊下颌骨牵张成骨中新骨形成的影响。
16 只山羊随机分为 4 组，每组 4 只。在 A、B 和 C 组中，每只山羊的右侧下颌骨以 0.8mm/d、1.6mm/d 和 2.0mm/d 的速度牵张；D 组为对照组，不进行牵张。牵张结束后 6 周，对所有组进行骨密度测定和三点弯曲试验。
A 组山羊的平均骨密度值明显高于其他组（p<0.05），C 组山羊的平均骨密度值明显低于其他组（p<0.05）。A、B 和 C 组的平均曲线斜率、峰值应力、弯曲模量和破坏能值均明显低于对照组（p<0.05）。随着牵张率的增加，曲线斜率和峰值应力值逐渐下降（p<0.05）。
尽管颅面骨血液供应丰富，但在下颌骨牵张成骨术中使用快速牵张率可能会对新骨质量产生不利影响。
