- 期刊
文獻回顧：上下顎骨和齒槽骨的牽引骨生成
Literature Review: Distraction Osteogenesis in Jaw Bone and Dentoalveolar Bone
摘要
牽引骨生成（distraction osteogenesis）簡稱DO，是藉由裝置牽引器（distractor），將現有骨組織進行截骨術（osteotomy），透過機械性拉張（mechanical stretching）的方式產生新組織。這些組織包含骨幣，肌肉，神經血管等等。本篇回顧探討DO和傳統引導骨再生術（conventional guided bone regeneration, GBR）以及傳統正顎手術（conventional orthognathic surgery, OGS）之比較，並整理了近年來關於DO在牙齒齒槽骨（dentoalveolar）和上下顎骨的病例報告、臨床研究和術後穩定度。DO的成功與否，和正確的手術治療計畫與技術有關。和傳統的OGS一樣，DO術前需要嚴謹的紙本和模型手術（paper and model surgery）以擬定distraction的術式。在進行DO的手術時，仍要避免不必要的手術外傷，以維持骨骼部位和周遭軟組織的活性。Distraction後，需要以X光片拍攝distractionsite，以判讀再生骨是否鈣化完全，這決定了強化期（consolidation period）的長短。明確的X光判讀後才可將distractor拆除，以減少術後復發。文獻顯示，對於上下顎需要大量往前移動的案例，DO比傳統正顎手術效果更佳。
並列摘要
Distraction osteogenesis (DO) is a surgical procedure that uses a distractor through an osteotomy site, by applying mechanical stretching forces to produce new organization. These organizations contain skeleton, muscles, nerves, blood vessels and so on.This article reviewed the comparisons of DO with conventional guided bone regeneration (GBR) and conventional orthognathic surgery (OGS), as well as the introduction of some of the recent case reports, clinical studies and post-surgery stability in relation to the dentoalveolus, maxilla and mandible regions.The success of Do is mainly related to the surgical treatment plan and the techniques. Same as the OGS, pre-surgical 00 also entails exact paper and model surgery for prediction of distraction method. For the 00 surgery, surgical trauma should be avoided to maintain the vitality of the skeletal structure and surrounding soft tissue. After the distraction, taking the X-ray of the distraction site is necessary to ensure the calcification of the regenerated bone, which determines the duration of consolidation period. The distractor can only be removed after a well calcified regenerated bone has been found on the radiograph.In conclusion, DO presents an alternative to conventional OGS that appears to have some advantages for large advancements in the maxilla and the mandible.
延伸閱讀
- 曾暐婷、陳順欣、洪珮娟、張文忠、藍明賢、姚宗珍、汪文琲（2015）。文獻回顧：下顎骨聯合。中華民國齒顎矯正學雜誌，27(1)，15-25。https://doi.org/10.30036/TJO.201508_27(1).0002
- 林昱均（2008）。骨性二級異常咬合合併下顎後縮者齒顎顏面形態測量學的探討〔碩士論文，高雄醫學大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0011-2406200823585600
- 洪君豪（2016）。下顎缺損腓骨重建與牙根支撐式局部義齒之生物力學分析〔碩士論文，義守大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0074-2508201618382400
- Adiguzel, O., Kaya, S., Yavuz, I., & Atakul, F. (2008). Oral Findings of Ectodermal Dysplasia and Literature Review. Journal of International Dental and Medical Research, 1(1), 43-49. https://www.airitilibrary.com/Article/Detail?DocID=1309100x-200809-201208080002-201208080002-43-49
- Hu, Z. M., Zhao, G., JunWang, L., Pu, B., Hao, J., Lao, H. C., Zhang, X. J., Gan, Q., & Jiang, W. (2013). Related Biological Research in the Interface between Bone Cement and Bone after Percutaneous Vertebroplasty. International Journal of Endocrinology, 2013(), 28-34-003. https://doi.org/10.1155/2013/109784