Alveolar Osteotomy による歯の移動に関する神経組織学的研究

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The present study was carried out to examine histopathologically and neuropathologically the changes in the wound healing process of the anterior teeth and periodontal tissue after segmental mandibular osteotomy of the anterior region in 1, 2, 3, 4, 6, 8, and 10 weeks of the operation. A. The general findings 1. New bone formation at the osteotomy region began within one week after the osteotomy. Osteotomized bone was united with basal bone three weeks after the osteotomy. Slight enlargement of blood vessels and hyperemia in the sectioned bone segment were observed after the surgery. But those phenomena disappeared and blood supply was restored to normal condition within four weeks after the osteotomy. 2. Enlargement of blood vessels and hyperemia in the periodontal ligament of anterior teeth were also observed, but the degeneration of the periodontal ligament did not occur in early postoperative stages. Three weeks after the operation, the condition of the periodontal ligament was restored to the former state. 3. Hypertrophy of the gingival and attached epithelium were observed from 1 to 10 weeks after the osteotomy. In detached adjacent to the cortical bone, granulation tissue with inflammatory cells proliferated and attached to the alveolar bone one week after the osteotomy. But the condition of the gingivae returned to near normal. B. The neural findings 1. All nerve fibers in the sectioned bone segment disappeared one week after the osteotomy. Two weeks after the osteotomy, regeneration of the nerve fibers from the basal bone fragment had just begun. Ten weeks after the osteotomy, the nerve fibers were smaller, and the distribution of nerve fibers was less than that of the control. In the dental pulp of the anterior teeth, enlargement of blood vessels and hyperemia were observed, but the degeneration was not found in the early postoperative stages. Four weeks after the osteotomy, the condition of the dental pulp was restored to its former state. 2. Nerve fibers in the periodontal ligament had all disappeared one week after the osteotomy. Three weeks after the regeneration of nerve fibers had begun from the region of the teeth, and the distribution of nerve fibers was present througout the entire periodontal ligament. However the nerve fiber distribution was less than that of the control, even 10 weeks after the osteotomy. 3. As the anterior mental nerve was cut by surgery, the nerve fibers of the upper part of the gingiva above the anterior mental foramen disappeared one week after the osteotomy. Three weeks after the osteotomy, regenerative nerve fibers were found in those areas. Nerve fiber distribution was less than that of the control ten weeks after the osteotomy. There were no changes in the nerve fibers of the lingual gingiva after the osteotomy. 4. In the dental pulp, the nerve fibers disappeared one week after the osteotomy. The regeneration of nerve fibers proceeded more slowly than that of the periodontal tissue in the dental pulp. However a few very fine regenerative nerve fibers were observed three weeks after the osteotomy. Subsequently, the number of nerve fibers increased gradually but ten weeks after the osteotomy the regenerative nerve fiber distribution was less than that of the control. As mentioned above, no pathological changes in the lingually displaced bone were observed, and favorable regeneration of nerve fibers was found after the osteotomy. It was concluded that the alveolar osteotomy was an extremely useful method of surgical correction in orthodontics.
九州歯科学会の論文
1986-10-25

Alveolar Osteotomy による歯の移動に関する神経組織学的研究

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