Liu Wei, Tang Xiao-Jun, Zhang Zhi-Yong, Yin Lin, Gui Lai
Department of Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Science, Peking Union Medical College, China.
Department of Craniomaxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Science, Peking Union Medical College, No 33, Ba-Da-Chu Road, Shi Jing Shan District, Beijing 100144, China.
J Craniomaxillofac Surg. 2014 Sep;42(6):763-71. doi: 10.1016/j.jcms.2013.11.008. Epub 2013 Nov 23.
The purpose of this study was to evaluate the role of periosteum on the healing and growth of mandible after mandibular outer cortex osteotomy using three-dimensional computed tomography.
Eighteen 3-month-old miniature pigs were randomized into three groups. The mandibular outer cortex osteotomy was performed on both sides in group I, and on the left side in group II. In groups I and II, the local periosteum on the left side was resected. In group III, no operation was performed. The evaluation of mandibular morphology of all the animals was performed based on multiple spiral CT data before and after surgery.
The bone defects healed well when the periosteum was preserved, whereas they healed poorly with residual bone defects when the periosteum was resected after surgery. When the periosteum was resected, the decrease in the mean thickness of the mandibular body was more than that of the contralateral side after surgery. In group I, about 66.7% of the animals exhibited mandible deviation at 24 weeks after surgery. The median point of mentum was inclined toward the side that the periosteum was preserved. In groups II and III, no mandible deviation was observed.
The periosteum plays an important role in bone growth and fracture healing. Mandibular outer cortex osteotomy inhibited the mandibular development and resulted in postoperative mandibular deviation in young miniature pigs. The simultaneous periosteum resection may offset the phenomenon of mandibular deviation to a certain extent.
本研究旨在利用三维计算机断层扫描评估骨膜在下颌骨外皮质截骨术后下颌骨愈合和生长中的作用。
将18只3月龄小型猪随机分为三组。I组双侧行下颌骨外皮质截骨术，II组左侧行下颌骨外皮质截骨术。I组和II组左侧局部骨膜切除。III组不进行手术。根据所有动物术前和术后的多层螺旋CT数据对下颌骨形态进行评估。
保留骨膜时骨缺损愈合良好，而术后切除骨膜时骨缺损愈合不良且有残余骨缺损。切除骨膜时，术后下颌体平均厚度的减少比另一侧更明显。I组约66.7%的动物在术后24周出现下颌骨偏斜。颏中点向保留骨膜的一侧倾斜。II组和III组未观察到下颌骨偏斜。
骨膜在骨生长和骨折愈合中起重要作用。下颌骨外皮质截骨术抑制了幼年小型猪的下颌骨发育并导致术后下颌骨偏斜。同时切除骨膜可能在一定程度上抵消下颌骨偏斜现象。
