Papadaki Maria E, Troulis Maria J, Glowacki Julie, Kaban Leonard B
Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA 02114, USA.
J Oral Maxillofac Surg. 2010 Nov;68(11):2783-91. doi: 10.1016/j.joms.2010.06.179.
To establish a porcine model for maxillary distraction osteogenesis and to document the sequence of bone formation in the zone of advancement.
Female Yucatan minipigs (n = 9) in the mixed dentition stage underwent modified Le Fort I osteotomy through a vestibular incision under general anesthesia. A unidirectional, semiburied Le Fort I distraction device was fixed across the osteotomy. The distraction protocol was 0-day latency, 1-mm/d rate for 12 days, and 24 days of fixation. Maxillary specimens (n = 9) were harvested and divided in half at the end of distraction (n = 6 sides), midfixation (n = 6), and the end of fixation (n = 6). Clinical stability, volume, and radiographic density across the zone of advancement were graded on semiquantitative scales. Specimens were stained with hematoxylin and eosin and examined with light microscopy.
Animals tolerated the operation, the distraction and fixation periods. There were no infections and no devices failed. At the end of the distraction period, bone trabeculae were present at the periphery and fibrous tissues, and vessels, preosteoblasts, and osteoblasts were present in the center of the zone of advancement. Islands of chondrocyte-like cells appeared in 1 specimen each at midfixation and the end of fixation. At the end of fixation, clinical stability and radiographic density were graded 3/3 and bone formation was complete across the advancement zone in all specimens.
A model for Le Fort I distraction osteogenesis was established. Intramembranous bone formation was the predominant mechanism of healing in the zone of advancement. Latency was not necessary for bone formation in this minipig model.
建立上颌骨牵张成骨的猪模型,并记录前移区域骨形成的顺序。
处于混合牙列期的雌性尤卡坦小型猪(n = 9)在全身麻醉下通过前庭切口接受改良的Le Fort I截骨术。将单向、半埋入式Le Fort I牵张装置固定于截骨处。牵张方案为:延迟0天,牵张速率为1毫米/天,持续12天,固定24天。在牵张结束时(n = 6侧)、固定中期(n = 6)和固定结束时(n = 6)采集上颌骨标本并将其对半切开。对前移区域的临床稳定性、体积和影像学密度进行半定量分级。标本用苏木精和伊红染色,并用光学显微镜检查。
动物耐受手术、牵张和固定期。无感染发生,且无装置失效。在牵张期末,前移区域周边出现骨小梁,中心存在纤维组织、血管、前成骨细胞和成骨细胞。在固定中期和固定期末,各有1个标本出现软骨样细胞岛。在固定期末,所有标本的临床稳定性和影像学密度分级均为3/3,且前移区域的骨形成完成。
建立了Le Fort I牵张成骨模型。膜内成骨是前移区域愈合的主要机制。在此小型猪模型中,骨形成无需延迟期。