Costantino P D, Friedman C D, Shindo M L, Houston G, Sisson G A
Department of Otolaryngology-Head and Neck Surgery, Loyola University Stritch School of Medicine, Maywood.
Arch Otolaryngol Head Neck Surg. 1993 May;119(5):511-6. doi: 10.1001/archotol.1993.01880170035007.
The use of gradual distraction to grow bone (distraction osteogenesis) has gained widespread orthopedic acceptance, but has only recently been applied to craniofacial skeletal defects. The use of bifocal distraction osteogenesis to fill experimental segmental mandibular defects with regenerate bone was recently reported. Though all canines in that study demonstrated normal oromandibular function, they were observed for only 4 weeks following defect closure. The study that is now reported describes the long-term (12-month) functional, morphologic, and biomechanical results when bifocal distraction osteogenesis was applied to the same model. In this long-term study, three canines had 2.5-cm unilateral segmental mandibular body defects filled with structurally stable bone using bifocal distraction osteogenesis. These dogs exhibited normal oromandibular function for 1 year following segment regrowth and external fixator removal. Macroscopic and histologic evaluation of the regrown segments revealed a re-formation of the cortical and medullary architecture. Stress testing demonstrated the average ultimate strength of the regrown segment at 53 MPa, which corresponded to 77% +/- 5.7% of normal mandibular bone. The data suggest that clinical trials applying this technique to segmental mandibular reconstruction are warranted.
采用逐步牵引来促进骨生长（牵张成骨术）已在骨科领域得到广泛认可，但直到最近才应用于颅面骨骼缺损。最近有报道称采用双焦点牵张成骨术用再生骨填充实验性节段性下颌骨缺损。尽管该研究中的所有犬在缺损闭合后仅观察了4周，但其口颌功能均正常。本报告所述的研究描述了将双焦点牵张成骨术应用于同一模型时的长期（12个月）功能学、形态学和生物力学结果。在这项长期研究中，三只犬的2.5厘米单侧节段性下颌骨体缺损通过双焦点牵张成骨术填充了结构稳定的骨。这些犬在节段再生和外固定器拆除后1年内口颌功能正常。对再生节段的宏观和组织学评估显示皮质和髓质结构重新形成。应力测试表明再生节段的平均极限强度为53兆帕，相当于正常下颌骨的77%±5.7%。数据表明将该技术应用于节段性下颌骨重建的临床试验是有必要的。
