Califano L, Cortese A, Zupi A, Tajana G
Department of Maxillofacial Surgery, Second School of Medicine and Surgery, Federico II University of Naples, Italy.
J Oral Maxillofac Surg. 1994 Nov;52(11):1179-83; discussion 1183-4. doi: 10.1016/0278-2391(94)90540-1.
To observe the development of bone at different times during the period of mandibular lengthening by external distraction using Ilizarov's transosseous osteosynthesis technique.
Fifteen rabbits, 2 to 3 kg in weight, were used for this experiment. The left side of the mandible was exposed and a corticotomy was performed with a water-cooled drill. After 12 hours, distraction was started and continued 1 mm per day for 2 weeks. Plain radiography and three-phase bone scan scintigraphy were performed on the 1st, 7th, and 14th postoperative days. The mandibles were then either removed for immediate histologic evaluation or after 2, 5, or 8 weeks of postdistraction fixation.
Elongation of up to 11 mm was achieved. Radiographic and scintigraphic evaluation suggested a residual inflammation on the 7th day and definite ossification on the 14th day. Histologic observations of the distraction site showed a gradual change from an amorphous matrix to a fibrous matrix and, finally, an osseous-like tissue.
Bone lengthening by gradual distraction is commonly used in tubular bones. To achieve mandibular lengthening it is necessary to resolve many problems. Morphologic, radiographic, scintigraphic, and histologic observations confirm that mandibular lengthening by external distraction is possible, with the formation of new bone tissue.
采用伊利扎洛夫经骨内固定技术，通过体外牵张观察下颌骨延长期间不同时间点的骨发育情况。
选用15只体重2至3千克的兔子进行本实验。暴露左侧下颌骨，用水冷钻头进行皮质切开术。12小时后开始牵张，每天牵张1毫米，持续2周。在术后第1天、第7天和第14天进行X线平片和三相骨扫描闪烁成像检查。然后将下颌骨取出，立即进行组织学评估，或在牵张后固定2、5或8周后进行评估。
实现了长达11毫米的延长。影像学和闪烁成像评估显示，第7天有残余炎症，第14天有明确骨化。牵张部位的组织学观察显示，从无定形基质逐渐转变为纤维基质，最终形成类骨组织。
逐渐牵张延长骨常用于管状骨。要实现下颌骨延长，有必要解决许多问题。形态学、影像学、闪烁成像和组织学观察证实，通过体外牵张实现下颌骨延长是可能的，会形成新的骨组织。
