皮質骨弁再植による家兎下顎骨骨欠損腔の治癒過程に関する実験的研究

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In enucleation of a comparatively large cyst or a benign tumor occurring in the mandible, the surrounding mandibular bone is often sacrificed. In such cases, impairments such as postoperative deformity of the alveolar bone and the mandibular bone, and delay in bone healing are feared. For such cases, if the labial cortical bone is cut out in the form of a round plate and a window is made, and then the plate is repositioned in its original place and secured after enucleation (experimental group), morphological deformity will be prevented and bone healing will be expedited. Clinically, intraoral approach is commonly used. For this study, however, extraoral approach was used with domestic rabbits as subjects. Subjects without replantation of the cortical plate and with the cavity left open were grouped as controls (control group), and a histopathological investigation was made. The results were as follows : 1. In the experimental group, reactive inflammation was slight and as compared with the control group, restitution of healing mechanism was seen. 2. Apposition of newly formed bone in the mandibular defect was seen in the cases of 5 days after operation on the lingual side and cavity side of the labial cortical bone in the experimental group. In the cases of 5 days after operation in the control group, new bone was seen only on the outside of the labial cortical bone. New bone on the inside of the labial side was seen in the cases of 10 days after operation. 3. Apposition of newly formed bone at the cut-end of the mandible was seen in the cases of 10 days after operation in the experimental group. Osseous union between the cut-end of the mandible and that of the cortical plate was seen in the cases of 10 days after operation. In the control group, on the other hand, edge-to-edge relationship of the cut-end of the mandible was seen in the cases of 20 days after operation. 4. In the experimental group, osteogenic repair was active in the cases from 20 to 30 days after operation, and osseous union between the replanted cortical bone and pre-existing bone became compact in the cases of 30 days after operation. Fat cells were observed in the central portion of the lacuna of the bone defect. In the control group, osteogenic repair was slightly delayed and the bone connecting the pre-existing bone presented compactness in the cases of 60 days after operation. Fat cells were seen in the central portion of the lacuna of the bone defect. 5. In experimental group, the profile of the mandible was nearly restored to the previous one, but considerable deformity of the profile occurred in the control group. 6. The foregoing findings indicate that under the cortical plate replantation technique, an operation under direct vision of the lesion is possible and little postoperative mandible deformity occurs because defect of bone cortex is nearly none. Postoperative bone healing also is fast because the operation wound is closed temporarily. Because of many advantages it offers, the technique is one of useful operation methods to be selected.
九州歯科学会の論文
1993-02-25

皮質骨弁再植による家兎下顎骨骨欠損腔の治癒過程に関する実験的研究

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