Senos R, Hankenson K D
Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, USA; Department of Biomedical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, USA.
Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, USA.
Injury. 2020 Jul;51(7):1509-1514. doi: 10.1016/j.injury.2020.04.041. Epub 2020 May 13.
Calvarial critical-size defects in rats are used to study regeneration of both craniofacial bone and long-bones. For decades, the trephine technique has been used with no notable refinements in the procedure. The use of piezoelectric surgical equipment has increased in human clinical oral and maxillofacial surgery, neurosurgery, traumatology, and orthopedics, because the devices are easy to handle, and can cut bone without damaging sensitive soft tissues such as blood vessels, nerves, and membranes. This study evaluated and compared the surgical technique and bone regeneration process between a traditional hand-drill trephine and piezoelectric equipment in a critical-size calvaria defect in a rat model. Thirty SD male rats were randomly divided into two groups and had either a 7.9mm diameter circular defect created with trephine or a 7.0mm square defect using the piezoelectric device, both creating 49 mm2 defect areas. MicroCT and histology were performed at 45 and 75d after surgery. While trephine surgeries were performed faster than piezoelectric (25.5 minutes vs 38.5 minutes), the rate of complications was much higher, with 36% of trephine rats taking 20 minutes to achieve hemostasis. Although the extent of new bone formation was similar between the two surgical groups, the piezoelectric technique resulted in 50% less variability. No additional new bone formation was observed from 45 to 75d in both techniques. Piezoelectric technique represents a refined and more reproducible technique for calvarial defect generation in comparison to classic trephine methods.
大鼠颅骨临界尺寸缺损用于研究颅面骨和长骨的再生。几十年来，环钻技术一直在使用，且该手术过程没有显著改进。在人类临床口腔颌面外科、神经外科、创伤学和骨科中，压电手术设备的使用有所增加，因为这些设备易于操作，并且能够在不损伤血管、神经和膜等敏感软组织的情况下切割骨头。本研究评估并比较了传统手摇钻环钻和压电设备在大鼠模型临界尺寸颅骨缺损中的手术技术和骨再生过程。30只雄性SD大鼠被随机分为两组，分别用环钻制造直径7.9mm的圆形缺损或用压电设备制造边长7.0mm的方形缺损，两者均产生49mm²的缺损面积。在术后45天和75天进行显微CT和组织学检查。虽然环钻手术比压电手术进行得更快（25.5分钟对38.5分钟），但其并发症发生率要高得多，36%的环钻组大鼠需要20分钟才能止血。尽管两个手术组之间新骨形成的程度相似，但压电技术导致的变异性降低了50%。在两种技术中，从45天到75天均未观察到额外的新骨形成。与经典环钻方法相比，压电技术是一种更精细、更可重复的颅骨缺损生成技术。
