下顎骨連続離断部への遊離骨膜移植に関する実験的研究

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There are lines of evidence of the osteogenic capacity of the free transplanted periosteum. However only a few experiments for the oral and maxillary region were found. Therefore, using two groups of adult dogs as experimental animals, the author made an experiment on the healing process of the wounds which were made on the mandibular bone by resection at spacing of 14mm and the free tibial periosteum was transplanted in one group (periosteum-grafted group) and was not done, the local periosteum alone was removed from the wounds in another (control group). The dogs were killed at intervals and the materials were prepared for histopathology. The staining was done with hematoxylin-eosin, van Gieson and PAM. Results obtained are summarized as follows : 1) At first, the regeneration of bone defect started with proliferation of fibrous tissue from the resected ends of the mandible in both groups. 2) The volume and form of the new bone trabeculae were different between the central end and the peripheral end of the mandible in both groups. The volume of the new bone at the central end was greater than that at the peripheral one. The new bone trabeclae showed a tendency to form toward the center of the bone cavity in a cordlike construction at the central end and to form like a honeycomb at the peripheral end in both groups. But there was little difference in the new bone volume between the two ends in the periosteum-grafted group. 3) The intrusion of circumferential soft tissues into the wound site and the cross running fibers at the site prevented the extension of the new bone from the resected ends after 5 weeks and bony continuity was not yet established after 12 weeks in the control group. 4) After 1 week, edematous swelling of the periosteal tissue could be seen and the periosteum entered the bone defect. Fibroblasts induced by the periosteal graft stimulated the regeneration of fibrous tissue. Then after 3 weeks, the cells with large and light-colored nuclei appeared in the swollen periosteal tissue. After 4 weeks, the cells differentiated into small cells with curled minute fibers and formed groups. Thereafter thick collagen fibers ran toward the periosteal tissue from the new bone induced by the small cells. The small cells in groups could no longer be observed at this site and appeared in the center of the periosteum. 5) The fibers parallel to the long axis of the mandible continuously induced the progress of the new bone and bony continuity progressed between the two ends after 12 weeks in the periosteum-grafted group. 6) Histopathologically, the bone defects at spacing of 14mm after mandibular resection were found to be helped to join with the intrusion of the circumferential soft tissues prevented and the new bone induced by periosteum. The transplantation of periosteum was thought to affect ossification significantly in this study.
1988-02-25

下顎骨連続離断部への遊離骨膜移植に関する実験的研究

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