下顎骨連続離断後の骨再生に関する実験的研究

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With the popularization of sports activities on one hand, and with ever increasing speeding-up of vehicles and traffic jaw on the other hand, we recently encounter very frequent cases of serious injuries of jaw bones accompanying fracture and defect. We also encounter not a few cases of mandibular tumors of benign or malignant nature and mandibular cysts of giant size, all of which demand the resection of the bone. The bone defects as produced in the foregoing cases are generally treated with the application of autogenous bone transplant for the sake of early recovery of function. Sometimes, materials other then the autogenous bone material have been utilized for the same purpose. Some reports are currently available, however, which have described successful treatment of the bone defect as produced either experimentally or clinically, without the use of any kind of materials for transplant. It may be acknowledged, however, that these studies have failded to make any comparative assessment of the healing processes when the local periosteum was either kept intact or removed from the wound. Using two groups of puppy as experimental animal, the present author made a series of comparative studies on the healing processes of wounds which were created on the mandibular bone by resection and where in one group of puppy the local periosteum was kept intact and in another removed from the wound. Results obtained were summarized as follows. 1. The time at which the regeneration of bone architecture started from resected ends of the mandible was confirmed by the appearance of radiological opacity and determined to be around 7 th day after the surgical resection for those bone where the periosteum was maintained intact, and around 14th day for those where the periosteum was removed from the wound. The histopathological study of the healing process of wound has revealed the regeneration of a small amount of bone architecture beginning as early as the 3 rd day after the resection in the periosteum-intact wound, and at around 5 th day after the resection in the periosteum-removed wound. This suggests a clear difference between the two processes of wound healing. 2. Connection of the resection ends of the bone by newly formed bone tissues was observed to occur at about 14 days after the resection in the periosteum-intact wound and about 60 days after the resection in the periosteum-removed wound, and this was confirmed either radiologically or histopathologically. Formation of the mandibular canal began to occur at about 30 post-operative days and was completed largely at about 60 post-operative days in the periosteum-intact group, while in the contrasting group of animal the formation began at about 60 post-operative days and was completed at about 120 post-operative days. This again suggested the significant role of intact periosteum in the healing process of mandibular bone defect. 3. When observed by means of histopathological procedures, repair of the damaged bone began at about 30 post-operative days in the periosteum-intact wound and at about 60 post-operative days in the periosteum-removed wound. At about 120 postoperative days, however, the repairing processes in mandibles of both groups of animal were still on the way in parallel so that there was noticed no significant difference in the pictures of both wounds. 4. It is well known that successful treatment of mandibular fracture and defect largely depends on the success or failure to secure the tight fixation of the free ends of resected bone. In another series of the present experiments, the author obtained favorable result in the treatment of such wounds by the use of Hirakawa's Implant for fixing purpose.
九州歯科学会の論文
1975-11-30

下顎骨連続離断後の骨再生に関する実験的研究

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