アブストラクト(27巻1号:神奈川歯学)

神奈川歯学

Japanese

Title : ポリ-L-乳酸メッシュを用いた新鮮自家骨髄海綿骨細片移植に関する研究 - 成犬皮下埋入実験 -
Subtitle : 原著
Authors : 田畑孝敏, 志村介三
Authors(kana) :
Organization : 神奈川歯科大学口腔外科学教室第2講座
Journal : 神奈川歯学
Volume : 27
Number : 1
Page : 62-80
Year/Month : 1992 / 6
Article : 原著
Publisher : 神奈川歯科大学学会
Abstract : 「緒言」顎顔面領域は種々の原因により骨欠損を生じるが, 顎顔面骨の形態と機能は極めて複雑であるため, その再建に際しては, さまざまな困難に直面する. 従来, これらの骨欠損に対して, 腸骨や肋骨を用いた自家ブロック骨移植が広く行われている. 近年, 生着率が高く, 骨形成に優れた骨髄を含む自家海綿骨骨梁細片particulate autogeneic marrow and cancellous bone, autogeneic particulate cancellous bone and marrow(以下PCBMと略す)移植の顎顔面骨再建への応用が注目されている. PCBM自体にはブロック骨のような移植直後の機械的な強度がなく, 欠損部の固定や支持体としての役割は期待できない. しかしこれは反面, スラリー状で, 造形の自由度が大きいということであり, 移植部の形態維持と支持体の役割を果たす組織内副子を併用するならば, 複雑な形態を有する顎顔面領域の再建に極めて益するところが大きい.
Practice : 歯科学
Keywords : 医用高分子, 加水分解, 移植, 骨形成, 再建

English

Title : A Study on Fresh Autogeneic Particulate Cancellous Bone and Marrow (PCBM) graft Supported with a Poly (L-Lactide) Mesh - Experiment on Subcutaneous Transplantation in Adult Dogs -
Subtitle :
Authors : Takatoshi TABATA, Kaizo Shimura
Authors(kana) :
Organization : The Second Department of Oral and Maxillofacial Surgery, Kanagawa Dental Collage
Journal : Kanagawa Shigaku
Volume : 27
Number : 1
Page : 62-80
Year/Month : 1992 / 6
Article : Original article
Publisher : Kanagawa Odontological Society
Abstract : Abstract: Poly (L-lactide) (PLLA) mesh has been developed as a biodegradable alloplastic tray to be used for the framework of fresh autogeneic particulate cancellous bone and marrow (PCBM) graft that can be used for the reconstruction of maxillofacial bone defects. We studied this mesh material, while applying it to a living body. During this study, we evaluated its effects on living tissues, especially on osteogenesis, and followed any changes in its mechanical strength. The experiment called for the insertion of PLLA meshes, monofilaments, and hollow mesh cylinders filled with PCBM under the dorsal skin of 22 adult dogs. Both histological and mechanical changes were noted. For the control experiment in the histological study, a mesh made of polypropylene (PP) was used. 1. The inflammatory response to the PLLA mesh was as slight as the response to the PP mesh. However, 3 months after the insertion, histiocytes and multinuclear giant cells appeared on the surface of the monofilament, and gradually increased in number, as the monofilaments of the mesh dissolved and disrupted. Fer inflammatory cells, however, invaded the zone surrounding the mesh, the adjacent tissues or the space between the monofilaments. 2. When a hollow-cylinder mesh mdae of PLLA and filled with PCBM was inserted subcutaneously, new bone formation was observed one week after the insertion as in the case of a similar mesh made of PP. The bone formation reached its peak one month after the insertion, and was observed roughly along the internal surface of the cylinder. In addition, a rich vascular net was formed within the cylinder through the monofilament meshwork. 3. The in vivo mechanical strengh of the test material did not vary for almost two months after the insertion, and 80% of its initial strengh was maintained for three months. Eventually, the mechanical strengh decreased rapidly untill it became nearly 0 after six months. 4. PLLA mesh could be easilly trimmed with scissors, and freely shaped into the desired form at the temparature of 70℃. On the basis of the abve, we concluded that PCBM graft supported by the usage of PLLA mesh tray would be very effective for the reconstruction of damaged maxillofacial bones, since histological tissue reaction associated with the biodegradation of the PLLA mesh were only slight in degree and limited in space. Moreover, our findings suggest that the PLLA mesh does not interfere with osteogenesis of PCBM, and maintains its mechanical strength long enough to allow the the transplant time to develop sufficient strengh to sustain the damaged region.
Practice : Dentistry
Keywords :