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A Study of Rigid Internal Fixation and Periosteal Injury Impacting Mandibular Growth

Author: WangYiBo
Tutor: HeLiSheng；TianLei
School: Fourth Military Medical University
Course: Clinical Stomatology
Keywords: Mandible Periosteum Rigid internal fixation Development
CLC: R782.4
Type: Master's thesis
Year: 2011
Downloads: 18
Quote: 0
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Abstract


Maxillofacial fractures in children, the most common mandibular fractures. Over the years, its focus on conservative treatment and surgical treatment of mandibular fractures in children has been controversial, treatment methods and the relationship of the maxillary. Some scholars believe that the stress shielding effect of rigid internal fixation produced inhibition of bone growth and development, and mainly intramembranous osteogenesis of the mandible, periosteal damage caused by the surgery affect the osteogenic potential of the periosteum and bone blood supply, which The bone development impact; Some scholars believe that the clinical efficacy of rigid internal fixation is a small positive impact on mandibular stable internal fixation and early functional training can make up for the bone growth restriction. The subject according to the clinical problem, with 20 70d age New Zealand white rabbits were randomly divided into two groups, each group of 10 animals were established periosteum injury model of rigid internal fixation model and mandible mandibular fractures explore rigid internal fixation periosteal damage growth and development of the mandible, experimental theoretical basis for the clinical treatment of children with mandibular fractures select. Establishment of rigid internal fixation of mandibular fracture model: right mandibular as the experimental group, causing a fracture in the body and the use of titanium miniplates fixed; left mandible as a control group, not the osteotomy and fixed only implanted two positioning titanium nails. The establishment of the mandible the periosteum injury model: right mandibular as the experimental group, scraping part periosteum implanted two positioning titanium nails; left mandible as a control group, do not scrape the periosteum, only titanium screw implanted in two positioning . All animals were at 3 months after surgery were sacrificed general observation, Micro-CT detection and histological observation. The results are as follows: 1) solid fixed and periosteal injury mandible no significant inhibition. 3 months after surgery, all the animals do not appear occlusal relationship disorders, both sides of the mandibular asymmetry and midline deflection phenomenon. 2) Rigid internal fixation of osteogenesis of the mandible developmental local quality produce adverse effects caused by the titanium plate fixed area of ??the experimental group mandibular cortical bone thickness, bone volume fraction smaller than that of the control group (P lt; 0.05), bone mineral density than the control group decreased, but no significant differences (P gt; 0.05). 3) periosteal injury can cause developmental decline in the quality of osteogenic mandibular partial, the experimental group periosteum scrape area mandibular cortical bone density, cortical bone thickness and bone volume fraction less than the control group (P lt; 0.05). 4) titanium plate and titanium screw implants will affect the mandibular localized osteogenic the mandible implants near the surface is not smooth, we can see some of the different sizes of the pores, poor continuity of the cortical bone, even in the presence of local bone resorption thinning so that portion dactylon exposed. In summary, we believe that rigid internal fixation with periosteal injury significantly inhibited the growth and development of the mandible without, but can affect developmental mandibular osteogenesis quality local mandible cortical bone thickness, bone volume fraction varying degrees reduced periosteal injury can also cause a decline in regional bone mineral density, but this degree of osteogenesis quality whether clinically significant further research is needed.

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CLC: > Medicine, health > Oral Sciences > Oral and maxillofacial surgery > Oral and Maxillofacial Trauma
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