富血小板血浆修复生长期兔髁突软骨损伤后下颌骨生长发育的三维评估研究

Three-dimensional analysis of mandibular growth after the repair of condylar cartilage injury in growing rabbits with platelet-rich plasma

目的建立生长期髁突软骨及软骨下骨损伤动物模型,利用Materialise Proplan CMF 3.0软件对下颌骨进行三维测量,探讨富血小板血浆(PRP)对生长期髁突软骨损伤修复及维持下颌骨生长发育的作用。方法生长期新西兰大白兔30只随机分为3组。PRP修复组(10只)建立髁突软骨及软骨下骨损伤动物模型后置入激活后的PRP;手术组(10只)建立髁突软骨及软骨下骨损伤动物模型;假手术组(10只)除不造成软骨及软骨下骨损伤外,其余与手术组相同。术后6周、12周对动物头颅进行螺旋CT扫描,采集SPCC格式数据。利用Materialise Proplan CMF 3.0软件对硬组织进行三维重建并分离上下颌骨,完整显露髁突的形态,确定标志点、参考平面及相应的测量指标,对测量结果进行统计学分析。结果各个时间点手术组动物各项测量指标的测量值均小于假手术组与PRP修复组动物的(P <0.05);术后6周,PRP修复组动物的下颌升支高度、髁突长度、髁突宽度测量值均小于假手术组的(P <0.05);PRP修复组动物的下颌体长度、髁突高度测量值与假手术组动物的相比差异无统计学意义(P> 0.05);术后12周PRP组动物的下颌升支高度、下颌体长度测量值均小于假手术组动物的(P <0.05),PRP修复组动物的髁突高度、髁突长度、髁突宽度测量值与假手术组动物的差异无统计学意义(P> 0.05)。结论生长期髁突软骨损伤后,下颌骨生长发育相对停滞,髁突发生吸收。激活后的PRP可有效修复生长期髁突软骨损伤,维持下颌骨的正常形态,促进下颌骨及髁突的正常生长发育。

ObjectiveAn animal model of condylar cartilage and subchondral bone injury during growing period is established,and three-dimensional measurement of mandibular was performed with Materialise Proplan CMF 3.0 software to investigate the effect of PRP on repairing condylar cartilage and maintaining mandibular growth in growing period.MethodsThirty growing New Zealand white rabbits were randomly divided into three groups. The PRP group animals(10)were implanted in activated PRP after the establishment of the animal model of condylar cartilage and subchondral bone injury.The condylar cartilage and subchondral bone injury models were established in the operation group(10).The sham operation group(10)was similar to the operation group except for the condylar cartilage and subchondral bone injury. At 6 and 12 weeks after surgery the animals received spiral computed tomography,and SPCC data were collected.Maxillary and mandibular three-dimensional reconstruction was performed using Materialise Proplan CMF 3.0. The upper and lower jaws were separated and the morphology of condylar was completely revealed. The result of measurement are analysed with statistical method after the determining the marking points,reference planes and corresponding measurement indexes.ResultsThe indexes of the operation group were all smaller than those of the sham operation group and the PRP group at each time poin(tP < 0.05);6 weeks after surgery,the height of mandibular ramus,the length of condyle and the width of condyle in PRP group were less than those in sham operation group(P < 0.05). There was no significant difference in mandibular length or condylar height between PRP group and sham operation group(P > 0.05). The mandibular ramus height and mandibular body length in PRP group were less than those in sham operation group at 12 weeks after operation(P <0.05). There was no significant difference in condylar height,length or width between PRP group and sham operation group(P > 0.05).ConclusionAfter the injury of mandibular condylar cartilage,the growth and development of mandibular are relatively stagnant,and the mandibular condyle is absorbed. Activated PRP can effectively repair the injury of condylar cartilage during growing period,promote the normal growth and development of mandible and condyle,and maintain the normal shape of mandible.