수여부와 블록 이식골의 동시 피질골 천공과 수여부 피질골 천공의 비교

COMPARISON THE CORTICAL PERFORATION OF BOTH THE RECIPIENT BEDS AND GRAFTS WITH THE CORTICAL PERFORATION OF ONLY THE RECIPIENT BEDS

  • 장인걸 (성균관대학교 의과대학 삼성서울병원 구강악안면외과) ;
  • 이동걸 (성균관대학교 의과대학 삼성서울병원 구강악안면외과) ;
  • 신창훈 (성균관대학교 의과대학 삼성서울병원 구강악안면외과) ;
  • 홍종락 (성균관대학교 의과대학 삼성서울병원 구강악안면외과)
  • Chang, In-Geol (Department of Oral and Maxillofacial Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee, Dong-Geol (Department of Oral and Maxillofacial Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Shin, Chang-Hoon (Department of Oral and Maxillofacial Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Hong, Jong-Rak (Department of Oral and Maxillofacial Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 발행 : 2009.12.31

초록

Purpose: The aim of this study is to compare volume and revascularization of autogenous block bone grafts in simultaneously cortical perforation of recipient beds and grafts, and only cortical perforation of recipient beds. Materials and methods: Two block bone in 8mm diameter was harvested in both skull using trephine bur on 20 New Zealand white rabbits. Harvested block bone was grafted on both inferior border of mandible. On the left side(experimental side), cortical bone of recipient beds and graft were perforated, and on the right side(control side), the only recipient bed was perforated. The rabbits had been sacrificed and infused the India ink for the observation of revascularization at 20 day and 40 day after surgery. The specimens were processed for H-E staining and quantitative analysis(independent t-test, p<0.01) was made under an optical microscope. In additional, specimens were processed for the observation of revascularization. Results: After 20 days, more bone volume was observed in experimental group, but no significant difference between two groups(p=0.106). There were significantly more bone volume in the experimental group at 40 days after surgery(p<0.01). After 20 days, more discrete vascular sprouts were observed in experimental side, but no difference at 40 days after surgery. Conclusion: We conclude that the cortical perforation of both the recipient beds and grafts improve revascularization at early stage and overall graft persistence.

키워드

참고문헌

  1. Chen NT, Glowacki J, Bucky LP, Hong HZ, Kim WK, Yaremchuk MJ: The roles of revascularization and resorption on endurance of craniofacial onlay bone grafts in the rabbit. Plast Reconstr Surg 1994;93:714-722; discussion 723-714 https://doi.org/10.1097/00006534-199404000-00009
  2. Hardesty RA, Marsh JL: Craniofacial onlay bone grafting: a prospective evaluation of graft morphology, orientation, and embryonic origin. Plast Reconstr Surg 1990;85:5-14; discussion 15 https://doi.org/10.1097/00006534-199001000-00002
  3. Kusiak JF, Zins JE, Whitaker LA: The early revascularization of membranous bone. Plast Reconstr Surg 1985;76:510-516 https://doi.org/10.1097/00006534-198510000-00003
  4. Lin KY, Bartlett SP, Yaremchuk MJ, Fallon M, Grossman RF, Whitaker LA: The effect of rigid fixation on the survival of onlay bone grafts: an experimental study. Plast Reconstr Surg 1990;86:449-456 https://doi.org/10.1097/00006534-199009000-00010
  5. Phillips JH, Rahn BA: Fixation effects on membranous and endochondral onlay bone-graft resorption. Plast Reconstr Surg 1988;82:872-877 https://doi.org/10.1097/00006534-198811000-00023
  6. Phillips JH, Rahn BA: Fixation effects on membranous and endochondral onlay bone graft revascularization and bone deposition. Plast Reconstr Surg 1990;85:891-897 https://doi.org/10.1097/00006534-199006000-00009
  7. Zins JE, Whitaker LA: Membranous versus endochondral bone: implications for craniofacial reconstruction. Plast Reconstr Surg 1983;72:778-785 https://doi.org/10.1097/00006534-198312000-00005
  8. Sullivan WG, Szwajkun PR: Revascularization of cranial versus iliac crest bone grafts in the rat. Plast Reconstr Surg 1991;87:1105-1109 https://doi.org/10.1097/00006534-199106000-00013
  9. Hammack BL, Enneking WF: Comparative vascularization of autogenous and homogenous-bone transplants. J Bone Joint Surg Am 1960;42-A:811-817
  10. Ray RD: Vascularization of bone grafts and implants. Clin Orthop Relat Res 1972;87:43-48
  11. Manson PN: Facial bone healing and bone grafts. A review of clinical physiology. Clin Plast Surg 1994;21:331-348
  12. Ozaki W, Buchman SR: Volume maintenance of onlay bone grafts in the craniofacial skeleton: micro-architecture versus embryologic origin. Plast Reconstr Surg 1998;102:291-299 https://doi.org/10.1097/00006534-199808000-00001
  13. Cho BC, Chung HY, Shin DP, Park JW, Baik BS: Early revascularization of membranous inlay bone graft in canine mandible model. J Craniofac Surg 2002;13:251-257 https://doi.org/10.1097/00001665-200203000-00012
  14. Alberius P, Gordh M, Lindberg L, Johnell O: Influence of surrounding soft tissues on onlay bone graft incorporation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996;82:22-33 https://doi.org/10.1016/S1079-2104(96)80373-8
  15. Alberius P, Gordh M, Lindberg L, Johnell O: Onlay bone graft behaviour after marrow exposure of the recipient rat skull bone. Scand J Plast Reconstr Surg Hand Surg 1996;30:257-266 https://doi.org/10.3109/02844319609056403
  16. Gordh M, Alberius P, Lindberg L, Johnell O: Bone graft incorporation after cortical perforations of the host bed. Otolaryngol Head Neck Surg 1997;117:664-670 https://doi.org/10.1016/S0194-5998(97)70050-0
  17. Buser D, Dula K, Hirt HP, Schenk RK: Lateral ridge augmentation using autografts and barrier membranes: a clinical study with 40 partially edentulous patients. J Oral Maxillofac Surg 1996;54:420-432; discussion 432-423 https://doi.org/10.1016/S0278-2391(96)90113-5
  18. Albrektsson T: Repair of bone grafts. A vital microscopic and histological investigation in the rabbit. Scand J Plast Reconstr Surg 1980;14:1-12 https://doi.org/10.3109/02844318009105731
  19. Goldstein JA, Mase CA, Newman MH: The influence of bony architecture on fixed membranous bone graft survival. Ann Plast Surg 1995;34:162-167
  20. Jackson IT, Adham M, Bite U, Marx R: Update on cranial bone grafts in craniofacial surgery. Ann Plast Surg 1987;18:37-40 https://doi.org/10.1097/00000637-198701000-00009
  21. Burchardt H: The biology of bone graft repair. Clin Orthop Relat Res 1983:28-42
  22. De Marco AC, Jardini MA, Lima LP: Revascularization of autogenous block grafts with or without an e-PTFE membrane. Int J Oral Maxillofac Implants 2005;20:867-874
  23. Deleu J: Vascularization of bone grafts in the anterior chamber of the eye. J Bone Joint Surg 1965;47:319-329
  24. Alberius P, Dahlin C, Linde A: Role of osteopromotion in experimental bone grafting to the skull: a study in adult rats using a membrane technique. J Oral Maxillofac Surg 1992;50:829-834 https://doi.org/10.1016/0278-2391(92)90274-4
  25. Jardini MA, De Marco AC, Lima LA: Early healing pattern of autogenous bone grafts with and without e-PTFE membranes: a histomorphometric study in rats. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005;100:666-673 https://doi.org/10.1016/j.tripleo.2005.03.020
  26. ten Bruggenkate CM, Kraaijenhagen HA, van der Kwast WA, Krekeler G, Oosterbeek HS: Autogenous maxillary bone grafts in conjunction with placement of I.T.I. endosseous implants. A preliminary report. Int J Oral Maxillofac Surg 1992;21:81-84 https://doi.org/10.1016/S0901-5027(05)80537-5
  27. Widmark G, Andersson B, Ivanoff CJ: Mandibular bone graft in the anterior maxilla for single-tooth implants. Presentation of surgical method. Int J Oral Maxillofac Surg 1997;26:106-109 https://doi.org/10.1016/S0901-5027(05)80827-6
  28. Smith JC: Membranous vs endochondral bone grafts. Arch Otolaryngol Head Neck Surg 1974;99:203-205 https://doi.org/10.1001/archotol.1974.00780030211011
  29. Jensen OT, Greer RO, Jr., Johnson L, Kassebaum D: Vertical guided bone-graft augmentation in a new canine mandibular model. Int J Oral Maxillofac Implants 1995;10:335-344
  30. Donos N, Kostopoulos L, Karring T: Augmentation of the rat jaw with autogeneic cortico-cancellous bone grafts and guided tissue regeneration. Clin Oral Implants Res 2002;13:192-202 https://doi.org/10.1034/j.1600-0501.2002.130210.x
  31. Hurzeler MB, Quinones CR, Schupbach P: Guided bone regeneration around dental implants in the atrophic alveolar ridge using a bioresorbable barrier. An experimental study in the monkey. Clin Oral Implants Res 1997;8:323-331 https://doi.org/10.1034/j.1600-0501.1997.080411.x
  32. Buser D, Bragger U, Lang NP, Nyman S: Regeneration and enlargement of jaw bone using guided tissue regeneration. Clin Oral Implants Res 1990;1:22-32 https://doi.org/10.1034/j.1600-0501.1990.010104.x
  33. Nishimura I, Shimizu Y, Ooya K: Effects of cortical bone perforation on experimental guided bone regeneration. Clin Oral Implants Res 2004;15:293-300 https://doi.org/10.1111/j.1600-0501.2004.01001.x
  34. Schmid J, Hammerle CH, Olah AJ, Lang NP: Membrane permeability is unnecessary for guided generation of new bone. An experimental study in the rabbit. Clin Oral Implants Res 1994;5:125-130 https://doi.org/10.1034/j.1600-0501.1994.050302.x
  35. Schmid J, Wallkamm B, Hammerle CH, Gogolewski S, Lang NP: The significance of angiogenesis in guided bone regeneration. A case report of a rabbit experiment. Clin Oral Implants Res 1997;8:244-248 https://doi.org/10.1034/j.1600-0501.1997.080311.x
  36. Kostopoulos L, Karring T: Guided bone regeneration in mandibular defects in rats using a bioresorbable polymer. Clin Oral Implants Res 1994;5:66-74 https://doi.org/10.1034/j.1600-0501.1994.050202.x
  37. Lundgren D, Lundgren AK, Sennerby L, Nyman S: Augmentation of intramembraneous bone beyond the skeletal envelope using an occlusive titanium barrier. An experimental study in the rabbit. Clin Oral Implants Res 1995;6:67-72 https://doi.org/10.1034/j.1600-0501.1995.060201.x
  38. Majzoub Z, Berengo M, Giardino R, Aldini NN, Cordioli G: Role of intramarrow penetration in osseous repair: a pilot study in the rabbit calvaria. J Periodontol 1999;70:1501-1510 https://doi.org/10.1902/jop.1999.70.12.1501
  39. Rompen EH, Biewer R, Vanheusden A, Zahedi S, Nusgens B: The influence of cortical perforations and of space filling with peripheral blood on the kinetics of guided bone generation. A comparative histometric study in the rat. Clin Oral Implants Res1999;10:85-94 https://doi.org/10.1034/j.1600-0501.1999.100202.x
  40. Shapiro F: Cortical bone repair. The relationship of the lacunarcanalicular system and intercellular gap junctions to the repair process. J Bone Joint Surg Am 1988;70:1067-1081 https://doi.org/10.2106/00004623-198870070-00016
  41. Trueta J, Morgan JD: The vascular contribution to osteogenesis. I. Studies by the injection method. J Bone Joint Surg Br 1960;42-B:97-109 https://doi.org/10.1302/0301-620X.42B1.97
  42. Nathanson A: The early vascularization of an autogenous bone inlay into an artificial defect in the rabbit mandibula. Acta Otolaryngol 1978;85:135-148 https://doi.org/10.3109/00016487809121434