Zhao Yan-Feng, Gui Lai, Liu Xiao-Jing
Department of Maxillofacial Surgery, Dalian City Central Hospital, Dalian, China.
Ann Plast Surg. 2010 Nov;65(5):475-9. doi: 10.1097/SAP.0b013e3181d37686.
The object of this study was to investigate the dimension change after bone of the outer mandibular table had been grafted to different facial recipient sites.
Six cases of hemifacial skeleton dysplasia had accepted therapeutics of onlay bone grafting at both mandibular angle and infraorbital regions of the affected side. Grafted bones had been harvested from the outer mandibular table of the uninjured side. For each patient, computed tomography scans were taken of immediate postoperative and 6 months postoperative results. By a technique based on 3-dimensional spiral computed tomography separated reconstruction and registration, grafted bones both at mandibular angle and infraorbital regions were independent. Volume of the grafted bone was measured, and 3-dimensional analysis was done.
At 6 months after the operation, the volume of the bone that had been grafted to the infraorbital region had a reduction rate of 11.2% ± 2.3%, and for the bone that had been grafted to the mandibular angle region, the volumetric reduction rate was 20.8% ± 7.2%. The difference of grafted bone resorption rate between the 2 recipient areas has statistical significance (<0.05). Three-dimensional analysis of grafted bones shows that the resorption took place mainly at the length-breadth direction and decreased thickness was less. Of the bone that had been grafted to the mandibular angle area, resorption mainly occurred at the inferior and posterior border of mandible.
As an autogenous bone graft resource for reparation and reconstruction of maxillofacial bone deformity, the outer mandibular table has a different rate of resorption after it had been onlay grafted to various maxillofacial recipient sites, and the difference of the local mechanical environment maybe an influencing factor. Quantization of bone resorption rate could better guide the clinical use of outer mandibular table as an onlay bone graft resource.
本研究的目的是调查下颌骨外板骨移植到不同面部受区后的尺寸变化。
6例半侧颜面骨骼发育不良患者在患侧下颌角和眶下区域接受了贴附植骨治疗。移植骨取自未受伤侧的下颌骨外板。对每位患者在术后即刻和术后6个月进行计算机断层扫描。通过基于三维螺旋计算机断层扫描分离重建和配准的技术,下颌角和眶下区域的移植骨是独立的。测量移植骨的体积,并进行三维分析。
术后6个月,移植到眶下区域的骨体积减少率为11.2%±2.3%,移植到下颌角区域的骨体积减少率为20.8%±7.2%。两个受区移植骨吸收速率的差异具有统计学意义(<0.05)。移植骨的三维分析表明,吸收主要发生在长径方向,厚度减少较少。移植到下颌角区域的骨,吸收主要发生在下颌骨的下缘和后缘。
下颌骨外板作为颌面骨畸形修复重建的自体骨移植来源,在贴附移植到不同颌面受区后具有不同的吸收速率,局部力学环境的差异可能是一个影响因素。骨吸收速率的量化可以更好地指导下颌骨外板作为贴附植骨来源的临床应用。