关键词：缝牵张；腭裂；组织再生
【摘要】 目的 探索腭裂修复新方法，采用缝牵张技术诱导犬腭骨外侧缝骨再生，补偿腭裂骨组织缺损，形成硬腭后部的骨性修复，避免传统手术存在的语音效果较差和面部发育障碍的不足。方法 用8周龄杂种犬9只，实验组经手术形成硬腭8mm宽的裂隙。用牵张力分别为200 g，360 g和480 g的镍钛形状记忆合金(NiTi-SMA)缝牵张器牵张腭骨外侧缝，使两侧腭骨向中线移动关闭裂隙。并设实验对照组和空白对照组。结果 实验对照组腭裂比手术时略有扩大；实验组则先后完全闭合，组织学发现实验组缝的骨缘有明显新骨形成。结论 幼犬腭裂可以通过缝牵张诱导骨组织再生补偿缺损，形成骨性修复；NiTi-SMA缝牵张器具有稳定可靠的牵张作用；三种不同牵张力值均能诱发缝区大量新骨形成，牵张力值较大者形成的新骨骨髓腔较大，骨小梁细长。
Suture expansionosteogenesis for closing the posterior hard palate:An experimental study in dogs
LIU Chunming* ,SONG Ruyao, SONG Yeguang. The General Hospital of People's Liberation Army, Beijing 100853
【 Abstract 】 Objective Thisstudy investigated the possibility of a new approach,e.g.suture expansion osteogenesis forclosing the posterior hard palate.By this technique we might hope to replace missingtissue in the clefts by tissue regeneration and achieve bony repair in the posterior hardpalate and circumvent the problems of speech and facial growth seen in traditional cleftsurgery.Methods Nine 8-month mongrel dogs were divided into threegroups:the control(n=1),sham control(n=2)and the experimental group(n=6).In sixexperimental dogs,an 8 mm wide cleft was made surgically.Suture expansion devices made of NiTi-shape memory alloy with force levels of 200g,360g and 480g were secured in thepalatine bones to expand the lateral sutures of the palatine bones.Clinical andhistological examinations were performed to observe the changes.Results The clefts in the experimental group were closed completely sooner or later within aperiod from 5 to 14 days.While the clefts in the sham group became a little larger thantheir original size.There was significant new bone formation at the edge of the expandedsuture.Conclusion The clefts in young dogs could be closed by thetechnique of suture expansion.The NiTi-SMA expander used in the study was consistentlyeffective and all the force levels could induce a great amount of new bone formation withthe trabeculae being thinner and longer by heavy forces.
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