Wang Lei, Cao Jian, Lei De-lin, Cheng Xiao-bing, Yang Yao-wu, Hou Rui, Zhao Ying-hua, Cui Fu-zhai
Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, China.
J Craniofac Surg. 2009 Nov;20(6):2188-92. doi: 10.1097/SCS.0b013e3181bf04c7.
Inferior alveolar nerve (IAN) injury is a concern in mandible distraction osteogenesis (DO). We have previously demonstrated that repeated local injections of human nerve growth factor beta (NGF-beta) have significantly enhanced the histologic recovery of the IAN in a rabbit model of DO. This study was to further test the effect of a single injection of human NGF-beta delivered via a collagen/nanohydroxyapatite/kappa-carrageenan gel to the recovery of the IAN in DO. Rabbits underwent mandibular DO at a rate of 0.75 mm/12 h for 6 days. At the end of the distraction period, injections were performed near the IAN percutaneously as follows: group 1, human NGF-beta in the gel; group 2, human NGF-beta in saline; group 3, the gel alone; and group 4, saline alone. At 14 days after the end of distraction, IAN histologic findings and histomorphometric parameters were evaluated. Histologically, there were less myelin debris and more abundant regenerating nerve fibers in group 1 than the other groups. Both the myelinated fiber density and the myelinated axon area in group 1 were significantly higher than groups 3 and 4 (P < 0.01); the myelinated axon area in the group 1 was significantly higher than group 2 (P < 0.01). In conclusion, the delivery of human NGF-beta in the gel leads to a better acceleration of the IAN injury recovery over the saline delivery. It provides a possible way to enhance the recovery of nerve injuries in craniofacial DO clinically.
下牙槽神经（IAN）损伤是下颌骨牵张成骨术（DO）中需要关注的问题。我们之前已经证明，在兔DO模型中，重复局部注射人β神经生长因子（NGF-β）可显著促进IAN的组织学恢复。本研究旨在进一步测试通过胶原/纳米羟基磷灰石/κ-卡拉胶凝胶单次注射人NGF-β对DO中IAN恢复的影响。兔以0.75 mm/12 h的速率进行下颌骨DO，持续6天。在牵张期结束时，经皮在IAN附近进行如下注射：第1组，凝胶中的人NGF-β；第2组，盐水中的人NGF-β；第3组，单独的凝胶；第4组，单独的盐水。在牵张结束后14天，评估IAN的组织学发现和组织形态计量学参数。组织学上，第1组的髓鞘碎片较少，再生神经纤维比其他组更丰富。第1组的有髓纤维密度和有髓轴突面积均显著高于第3组和第4组（P < 0.01）；第1组的有髓轴突面积显著高于第2组（P < 0.01）。总之，与盐水给药相比，凝胶中人NGF-β的给药能更好地加速IAN损伤的恢复。它为临床上提高颅面DO中神经损伤的恢复提供了一种可能的方法。
