Alyessary Akram S, Yap Adrian U J, Othman Siti A, Rahman Mohammad T, Radzi Zamri
Doctoral Student, Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia; Lecturer, Department of Orthodontics, College of Dentistry, Karbala University, Karbala, Iraq.
Head and Senior Consultant, Department of Dentistry, Ng Teng Fong General Hospital, JurongHealth Services, Singapore; Adjunct Professor, Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.
J Oral Maxillofac Surg. 2018 Mar;76(3):616-630. doi: 10.1016/j.joms.2017.08.018. Epub 2017 Aug 17.
The present study investigated the effect of piezoelectric sutural ostectomies on accelerated bone-borne sutural expansion.
Sixteen male New Zealand white rabbits (20 to 24 weeks old) were randomly divided into 4 experimental groups (n = 4): group 1, conventional rapid sutural expansion; group 2, accelerated sutural expansion; group 3, accelerated sutural expansion with continuous ostectomy; and group 4, accelerated sutural expansion with discontinuous ostectomy. All sutural ostectomies were performed using a piezoelectric instrument (Woodpecker DTE, DS-II, Guangxi, China) before expander application with the rabbits under anesthesia. Modified hyrax expanders were placed across the midsagittal sutures of the rabbits and secured with miniscrew implants located bilaterally in the frontal bone. The hyrax expanders were activated 0.5 mm/day for 12 days (group 1) or with a 2.5-mm initial expansion, followed by 0.5 mm/day for 7 days (groups 2 to 4). After 6 weeks of retention, the bone volume fraction, sutural separation, and new bone formation were evaluated using micro-computed tomography and histomorphometry. Statistical analysis was performed using Kruskal-Wallis and Mann-Whitney U tests and Spearman's rho correlation (P < .05).
Ranking of the median sutural separation was as follows: group 1, 3.05 mm; group 2, 3.97 mm; group 4, 4.78 mm; and group 3, 5.66 mm. The least and most bone formation were observed in groups 1 (63.63%) and 3 (75.93%), respectively. Spearman's correlation showed a strong, positive, and significant correlation (r = 0.932; P < .01) between the new sutural bone formation and amount of sutural separation.
Piezoelectric sutural ostectomies increased the rate of sutural separation and promoted new sutural bone formation/osteogenesis. Continuous ostectomy gave better results than discontinuous ostectomy.
本研究调查了压电性缝骨切除术对加速骨源性缝扩张的影响。
16只雄性新西兰白兔（20至24周龄）被随机分为4个实验组（n = 4）：第1组，传统快速缝扩张；第2组，加速缝扩张；第3组，连续骨切除术的加速缝扩张；第4组，间断骨切除术的加速缝扩张。在麻醉下对兔子应用扩张器之前，使用压电仪器（啄木鸟DTE，DS-II，中国广西）进行所有缝骨切除术。改良的Hyrax扩张器横跨兔子的矢状缝放置，并用位于双侧额骨的微型螺钉植入物固定。Hyrax扩张器在第1组中以每天0.5毫米的速度激活12天，在第2至4组中以2.5毫米的初始扩张开始，随后以每天0.5毫米的速度扩张7天。保留6周后，使用微型计算机断层扫描和组织形态计量学评估骨体积分数、缝分离和新骨形成。使用Kruskal-Wallis和Mann-Whitney U检验以及Spearman秩相关进行统计分析（P <.05）。
缝分离中位数的排名如下：第1组，3.05毫米；第2组，3.97毫米；第4组，4.78毫米；第3组，5.66毫米。在第1组（63.63%）和第3组（75.93%）中分别观察到最少和最多的骨形成。Spearman相关性显示新的缝骨形成与缝分离量之间存在强的、正的且显著的相关性（r = 0.932；P <.01）。
压电性缝骨切除术增加了缝分离的速率并促进了新的缝骨形成/骨生成。连续骨切除术比间断骨切除术效果更好。
