Durmus Muzaffer, Zor Fatih, Ozturk Serdar, Bozlar Ugur, Turegun Murat, Sengezer Mustafa
Diyarbakir Military Hospital, Diyarbakir, Turkey.
J Oral Maxillofac Surg. 2010 Apr;68(4):756-61. doi: 10.1016/j.joms.2009.04.135. Epub 2009 Dec 2.
The aim of this study is to assess 3-dimensional reconstruction of cranial defects by use of bifocal bidirectional transport distraction osteogenesis (BBTDO).
This study was performed on 8 sheep, divided into a control group (n = 3) and treatment group (n = 5). Full-thickness cranial defects (50 x 40 mm) were created on calvaria. In the control group only the skin was closed. In the treatment group BBTDO was performed. Distraction was performed with a custom-made distraction device with a transport segment of 40 x 20 mm. After a 5-day period of latency, distraction was applied to the transport segment. During the first 20 days of distraction, the transport segment was distracted 1 mm in the forward direction and 0.5 mm in the upward direction. After the next 20 days of distraction, the transport segment was distracted 1 mm forward and 0.5 downward. After a total of 40 days' distraction, a 30-day consolidation period was applied. Macroscopic, radiologic (computed tomography with volume measurements), and histologic evaluations were done.
No major complications were seen during the whole study period. In the control group the bone defects remained unhealed at the end of the study period. The same-sized defects in the treatment group healed with a convexity like the calvaria. Preoperative and postoperative cranial volume measurements of the treatment group animals showed an increase in cranial volume (P < .05). Histologic evaluation showed inductive bone regeneration and mature bone structure development within the distraction zone.
The BBTDO is an effective and safe technique for 3-dimensional closure of cranial defects.
本研究旨在评估使用双焦点双向运输性牵张成骨术（BBTDO）对颅骨缺损进行三维重建的效果。
本研究对8只绵羊进行，分为对照组（n = 3）和治疗组（n = 5）。在颅骨上制造全层颅骨缺损（50×40毫米）。对照组仅缝合皮肤。治疗组实施BBTDO。使用定制的牵张装置进行牵张，运输段尺寸为40×20毫米。经过5天的延迟期后，对运输段施加牵张。在牵张的前20天内，运输段向前牵张1毫米，向上牵张0.5毫米。在接下来的20天牵张后，运输段向前牵张1毫米，向下牵张0.5毫米。总共牵张40天后，进行30天的巩固期。进行了宏观、放射学（容积测量的计算机断层扫描）和组织学评估。
在整个研究期间未观察到重大并发症。对照组在研究期结束时骨缺损仍未愈合。治疗组相同大小的缺损愈合后呈现出类似颅骨的凸面。治疗组动物术前和术后的颅骨容积测量显示颅骨容积增加（P <.05）。组织学评估显示在牵张区内有诱导性骨再生和成熟骨结构的发育。
BBTDO是一种有效且安全的三维闭合颅骨缺损的技术。
