Biomechanical and histological analysis of alveolar distraction osteogenesis in a canine model

doi:10.3969/j.issn.2095-4344.2014.20.018

Abstract

Abstract:

BACKGROUND: Alveolar distraction osteogenesis is an important method for treating alveolar bone atrophy, the osteogenesis process and biomechanics play a crucial role in the following implantation and repair. At present, no related experimental studies are found.
OBJECTIVE: To analyze the biomechanical and histological characteristics of alveolar distraction osteogenesis in a canine model.
METHODS: Twelve adult mongrel canines received premolars extraction and alveoloplasty in mandible to establish an atrophy alveolar model. After 3 months, a segmental alveolar osteotomy was performed in the randomly selected unilateral atrophy alveolar and two intra-osseous distractors were placed. After a 7-days latency period, the alveolar ridge was augmented at a rate of 1.0 mm/d for 5 days. After a consolidation of 1, 2,
and 3 months, the canines were sacrificed and the specimens of the distracted alveolar bone were harvested for clinical, radiographic, histological and biomechanical analysis.
RESULTS AND CONCLUSION: The alveolar distractors obtained good healing with surrounding tissue. The atrophy alveolar bones were augmented for (4.80±0.50) mm and (5.12±0.47) mm by clinical and radiographic findings immediately after distraction, respectively. The bone trabeculae in the distracted chamber matured from 1 to 3 months of consolidation by histological analysis. The shearing force of alveolar distraction chamber increased from 1 to 3 months. After 3 months’ consolidation, the shearing force of distracted chamber was comparable to host bone. The histological and biomechanical property of distracted alveolar chamber is comparable to host bone after 3 months’ consolidation.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

全文链接：

Key words: osteogenesis, distraction, mechanics, histology, dental implantation

CLC Number:

R318

Zhou Miao, Che Yue-juan, Guo Ming-yan, Huang Dai-ying, Piao Zheng-guo, Yu Xiao-wei, Chen Song-ling. Biomechanical and histological analysis of alveolar distraction osteogenesis in a canine model[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(20): 3212-3217.

Figures/Tables 1

2.1 临床检查所有的动物能耐受整个手术和牵张过程。有1只出现伤口感染导致牵张器排出，其余伤口愈合正常。固定期0，1，2和3个月的临床牙槽嵴增加高度值分别为(4.80±0.50) mm，(4.67±0.31) mm，(4.41±0.19) mm和(4.32±0.21) mm，增加高度随固定时间延长有所降低。在牵张后2个月复查，舌侧骨板触诊坚硬、连续性好。在整个观察期，唇侧骨面触诊粗糙。牙槽黏膜和牙龈颜色未出现明显改变。牵张器与周围组织愈合良好。 2.2 放射学检查种植体植入后放射学检查显示牵张器就位良好，在输送盘和基骨间有约1 mm的阴影。所有的牵张器都可使输送盘增高，输送盘两端有明显的骨突。固定期1个月时，发现输送盘与基骨之间有明显的透射区，输送盘两端与基骨的界限变模糊，骨突明显变钝。颊侧的透射影比舌侧更明显。垂直向观察，牵张区中部透射最明显，向两端密度逐渐变高(图2A)。固定期2个月时，牵张区的阻射较1个月明显上升，牵张区与基骨和输送盘的界限隐约可见。输送盘两端的骨突与邻近骨连接平滑。牵张区的阻射为舌侧高于颊侧、两端高于中间(垂直向)。颊侧的阴影区较1个月时明显减少(图2B)。固定期3个月时，牵张区阻射较2个月又有提高。牵张区舌侧骨与基骨和输送盘阻射程度无分别。颊侧牵张区可见中间段向舌侧凹陷。螺纹杆周围骨质成明显阻射影。整个牵张器与周围骨紧密结合，未见阴影区(图2C)。固定期0，1，2和3个月的放射学牙槽嵴高度增加值分别是(5.12±0.67) mm，(4.92±0.57) mm，(4.73±0.46) mm和(4.58±0.35) mm，增加高度随固定时间延长而降低。 2.3 组织学检查固定期1个月时，牵张区可见由3个区组成：与两边的宿主骨交界处为疏松的、网状骨小梁，中间为纤维组织区。牵张区未发现有软骨的存在，骨组织主要是由纤维组织中的间充质细胞直接分化为骨母细胞，再分化为成骨细胞产生新生骨，新生骨进一步改建、成熟。在骨小梁区，可看到靠近中间的部分较为幼稚，骨小梁纤细，有时在纤维组织中直接形成骨岛；在接近宿主骨的部分，骨小梁逐渐致密、粗大，并向板状骨过渡，形成陷窝状的编织骨。在新生骨小梁的周围有成骨细胞规则地围绕，提示有活跃的成骨。纤维结构区可见纤维组织排列与牵张方向一致，其间可见大量的毛细血管，新生血管的方向与牵张方向一致(图3A)。在整个牵张区未发现软骨成骨区，说明牙槽骨牵张成骨术的骨愈合是以膜内成骨的方式进行的，与骨折愈合的方式明显不同。固定期2个月时，大部分的牵张区由网状的骨小梁组成。骨小梁的结构较1个月时变粗，变密和规则。在骨小梁的周围可见成骨细胞围绕。舌侧骨板由完整的骨小梁连接；在颊侧，有软组织向内生长，使颊侧牵张区形成凹陷，这与放射学检查的结果一致(图3B)。固定期3个月时，牵张区主要由板状骨和编织骨组成，有规则的哈弗管。骨组织间的血管密度较1个月、2个月有降低。可观察到骨组织的血管方向与牵张方向一致。板状骨中可以观察到破骨细胞，提示存在骨的形成与改建(图3C)。 2.4 生物力学检测比较1个月组、2个月组、3个月组与对照组的剪切力发现：牵张区的剪切力值随着固定期的延长而上升，1个月组、2个月组与3个月组间比较差异有显著性意义(P < 0.05)，3个月组与对照组比较差异无显著性意义(P > 0.05)，见图4。"

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