牵引速率及频率对牵张成骨的影响

Effects of distraction rate and frequency on distraction osteogenesis

背景：牵张成骨在口腔颌面外科的临床应用非常广泛。在矫正小颌畸形、下颌后缩、半侧颜面萎缩,修复颌骨缺损,牙槽嵴增高等方面具有独特的优势及应用前景。目的：阐述在动物实验中不同牵引速率和频率对牵张成骨的影响。方法：由作者分别以＂牵张成骨,牵引速率,牵张频率＂和＂distractionosteogenesis,distraciton rate,distraetion frequencies＂为检索词在中国期刊全文数据库（CNKI：1989/2009）和Medline database数据库（1989/2009）,采用电子检索的方式进行文献检索,共检索到58篇文章,纳入25篇分析全面的动物实验及治疗进展类文章,分别从不同牵引速率及频率对牵张成骨的影响进行总结。结果与结论：牵引速率和频率是影响牵张成骨效果及疗程的关键因素之一,过小的牵引率达不到刺激新骨生成的目的,过大的牵引速率能会导致纤维组织形成而无新骨生成,甚至造成骨不连。在一定的牵引速度下增加牵引频率可促进成骨,高频率牵引或连续牵引是促进牵张成骨的有效方法。动物实验证实1mm/d牵引,2~4次/d的频率成骨的质量和数量效果最好。

BACKGROUND： Distraction osteogenesis has become increasingly popular for the treatment of craniofacial anomalies involving the midface and mandible. OBJECTIVE： To investigate the effect of distraction rate and frequencies on distraction osteogenesis. METHODS： The first author retrieved CNKI database from 1989 to 2009 in Chinese and Medline database from 1989 to 2009 in English with the Key words of ＂distraction osteogenesis, distraction rate, distraction frequencies＂. A total of 58 articles were screened according to inclusion and exclusion criteria. Finally, 25 articles concerning the effect of distraction rate and frequencies on distraction osteogenesis were included. RESULTS AND CONCLUSION： Distraction rate and frequencies affected outcomes of distraction osteogenesis. The small distraction rate can not stimulate new bone formation, while the great distraction rate may lead to inogenesis rather than new bone formation, even worse, may lead to bone union. Under a certain distraction rate, increasing of distraction frequency may promote osteogenesis. Distraction with high rate or continuous traction is effective in promoting osteogenesis. The distraction frequencies of 2-4 times with 1 mm per day proved to be biomechanically superior.