Hämmerle C H, Schmid J, Lang N P, Olah A J
University of Bern, Switzerland.
J Oral Maxillofac Surg. 1995 Feb;53(2):167-74. doi: 10.1016/0278-2391(95)90396-8.
The objective of this study was to histologically evaluate the early stages of bone regeneration using rabbit calvaria defects in conjunction with guided tissue regeneration.
A semilunar cutaneous-periosteal flap was raised on the forehead of four rabbits exposing the top of the skull. A standardized transosseous skull defect (> or = 15 mm in diameter) was made in the area of the right parietal bone with a rotating round bur. Care was taken not to damage the underlying dura. A flat expanded polytetrafluoroethylene (ePTFE) membrane was placed to cover the defect. The membrane was tightly adapted, extending at least 4 mm onto intact bone, and the flap was sutured. One, 2, 3, and 5 weeks later, the specimens were removed and processed using standard, undecalcified, hard-tissue histologic techniques. Contact radiographs were also taken.
Bone growth increased with time, starting at the borders of the defect. At 1 week, trabeculae of woven bone grew into the highly vascularized loose connective tissue occupying the defect. Two weeks postsurgery, isolated islands of new bone were detected in this connective tissue. Subsequently, neighboring small islands merged to form large islands. In later stages, the primary trabeculae of woven bone were reinforced by layers of regularly deposited lamellar bone.
Rabbit calvaria defects treated by guided tissue regeneration heal by ingrowth of woven bone from the defect margins and by formation of bony islands within the defect area. Bone healing showed the histophysiological characteristics of intramembranous bone.
本研究的目的是通过兔颅骨缺损结合引导组织再生技术，对骨再生的早期阶段进行组织学评估。
在4只兔子的前额掀起半月形皮肤 - 骨膜瓣，暴露颅骨顶部。用旋转圆钻在右侧顶骨区域制造标准化的经骨颅骨缺损（直径≥15毫米）。注意不要损伤下方的硬脑膜。放置一块扁平的膨化聚四氟乙烯（ePTFE）膜覆盖缺损。膜紧密贴合，至少延伸到完整骨上4毫米，然后缝合皮瓣。1、2、3和5周后，取出标本并使用标准的、不脱钙的硬组织组织学技术进行处理。还拍摄了接触式X线片。
骨生长随时间增加，始于缺损边缘。1周时，编织骨小梁长入占据缺损的高度血管化疏松结缔组织中。术后2周，在该结缔组织中检测到孤立的新骨岛。随后，相邻的小骨岛合并形成大骨岛。在后期，编织骨的初级小梁被规则沉积的板层骨层加强。
通过引导组织再生治疗的兔颅骨缺损通过缺损边缘的编织骨向内生长和缺损区域内骨岛的形成而愈合。骨愈合显示出膜内成骨的组织生理特征。
