Liang Limin, Liu Chunming
Department of Oral and Maxillofacial Surgery, the General Hospital and Postgraduate Medical College of Chinese P.L.A., Beijing, China.
Cleft Palate Craniofac J. 2012 Nov;49(6):701-7. doi: 10.1597/10-250. Epub 2011 Aug 1.
To explore a new method of repair of alveolar cleft by trans-sutural distraction osteogenesis.
Nine 8-week-old mongrel dogs were assigned randomly to two groups with three in the control group and six in the experimental group.
First, an alveolar cleft model was created surgically in all animals. After 2 weeks, a U-shaped distractor, made of nickel-titanium (NiTi) shape memory alloy wire with 200 g tensile force, was inserted into the premaxilla of the experimental dogs to distract the mid-premaxillary suture for 3 weeks. Periosteoplasty of the alveolar cleft was performed when the premaxilla at the side of cleft approached the maxilla at the same side. The distractor was removed 2 weeks post periosteoplasty.
The results were evaluated clinically, radiographically, and morphologically.
The cleft model was stable and similar to the human alveolar cleft. No spontaneous bone union occurred in the control. In experimental dogs, the premaxilla was moved slowly toward the maxilla, and the cleft became gradually narrower and closed in the third week. Radiographically, the distracted mid-premaxillary suture showed a gradually widened triangle, with the tip of the triangle pointed posteriorly. The density of the distracted triangle suture was increased gradually. The alveolar cleft was completely bony 3 months post periosteoplasty. The morphology of the mid-premaxillary suture was also restored.
The alveolar cleft could be repaired by the technique of mid-premaxillary suture distraction using the elastic device of NiTi shape memory alloy.
探索经缝牵引成骨修复牙槽嵴裂的新方法。
将9只8周龄的杂种犬随机分为两组，对照组3只，实验组6只。
首先，对所有动物进行手术创建牙槽嵴裂模型。2周后，将由镍钛（NiTi）形状记忆合金丝制成、具有200g拉力的U形牵张器插入实验组犬的前上颌骨，牵引前上颌骨缝3周。当裂隙侧的前上颌骨接近同侧上颌骨时，对牙槽嵴裂进行骨膜成形术。骨膜成形术后2周取出牵张器。
从临床、影像学和形态学方面评估结果。
裂隙模型稳定，与人类牙槽嵴裂相似。对照组未发生自发性骨愈合。在实验组犬中，前上颌骨缓慢向同侧上颌骨移动，裂隙在第3周逐渐变窄并闭合。影像学显示，牵引后的前上颌骨缝呈逐渐增宽的三角形，三角形尖端指向后方。牵引后的三角形骨缝密度逐渐增加。骨膜成形术后3个月牙槽嵴裂完全骨性愈合。前上颌骨缝的形态也得以恢复。
使用镍钛形状记忆合金弹性装置通过前上颌骨缝牵引技术可修复牙槽嵴裂。
