下颌支斜行切开术后骨皮质重叠愈合的生物学基础研究

An Experimental Study on the Biological Basis of Cortex to cortex Bone Healing after Oblique Ramus Osteotomy

为阐明斜行骨切开术后骨皮质重叠愈合的过程及其生物学基础，对１２只成年猕猴施行双侧下颌支斜行切开术，术后３、６、１２周和２４周取标本进行下颌支横断面磨片观察和组织学观察，并对２只动物实施术后立即微血管造影检查。结果显示：术后下颌支近心骨段仍有较好的血管充盈，骨段下端无局灶坏死。骨皮质重叠愈合的主要方式为包绕骨断端的大量外骨痂形成，骨皮质重叠区内的骨痂形成较周围慢，至术后２４周骨切开部位的内外侧厚度达正常下颌支的２～３倍。结论：下颌支斜行切开术后近中骨段未出现严重的血供下降，通过大量外骨痂的形成，骨皮质重叠可以获得良好的愈合。

This study was designed to elucidate biological basis of cortex to cortex bone healing after oblique ramus osteotomy. 12 rhesus monkeys were subjected to oblique ramus osteotomy bilaterally, and the operated sites were examined by microvascular irrigation section and histology techniques. The results showed that, besides the blood supply from the attachment of lateral pterygoid muscles and capsule of temporomandibular joint to the medial segments, the blood supply from the attachment of medial pterygoid muscles also played an important role. Cortex to cortex bone healing was achieved by the formation of a large volume of scab surrounding the operated sites. It is concluded that oblique ramus osteotomy has its good biological basis both in blood supply and cortex to cortex bone healing process.