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顎骨骨移植의 實驗的硏究

Bone Homografts of the Jaw

현대의학 1969년 10권 2호 p.275 ~ 282
김규식,
소속 상세정보
김규식 (  ) - 서울대학교 치과대학 구강외과교실

Abstract


Bone grafting has been the subject of extensive studies for many years.
The literature is replete with the articles which describe auto-homo-, hetero-grafting and other bone substitutes implantation experiments in animals.
This study was primarily concerned with the fate of three different homotransplants that consisted of cold-stored, boiled and formalin-treated banes of ribs in the mandible of rabbits.
It was observed in terms of roentgenographic and histological changes, and examined changes of body temperature and leucocyte count pre- and post-operatively.
Materials and Methods:
The homologous,?boine transplants were obtained from resected ribs of the other rabbits and transplants were approximately 0.8ⅹ0.2cm. In size. The homologous transplants divided into three ´different types; cold-stored, boiled and formalin-treated bones.
1) Cold-stored homologous bone: transplants were prepared without periosteum and immediately placed in test tubes containing isotonic saline solution and preserved in the ice \box at 2~4℃ for 3 to 7 days.
2) Boiled homologous bone: The periosteum of ribs was removed and placed in the test tubes containing sterile aqueous solution and boiled for 15 minutes. And then tubes were sealed in aseptic condition for 1~3 days. Before bone grafting the transplants were washed with normal saline solution for 60 minutes.
3) Formalin-treated homologous bone: transplants were placed in 10% formalin solution for 5 to 7 days and washed with sterile aqueous solution for 24 hours before surgery and kept in the normal saline solution.
4 to 6 months old rabbits having body weight of 1,700 - 2,OOOGm were selected first, and they were re-selected after well - nourished period of one month. 25% Urethane solution was used for the ´general anesthesia of the experimental animals and area to be operated was additionally´ anesthetized with 2% Xylocaine hydrochloride with 1 : 50,000 epinephrine.
Ordinary pre operation aseptic and other preparations were maintained.
Incision was made along the inferior border of mandible and bony surface was exposed after separating muco-periosteunr. With fissure ´bur, the host site was cut to the size of 0.8ⅹ0.2cm and both end margins were prepared a small hole for stabilization of transplant. And transplants were placed in the host defective site and stabilized with 5-0 tantalum suture through holes. Soft tissues were placed back and sutured.
At post-operative intervals of 1, 2, 4, and 8 weeks the animals were killed. The mandible was dissected out and placed in 10% formalin solution for adequate fixation. These specimens were then decalcified, embedded in celloidine, sectioned, stained with Hematoxylin and Eosin.
Results:
1) In all homograft cases, the post-operative body temperature was elevated and also leucocyte count was increased in number until 5 to 8th week after surgery.
2) Roentgenographic finding: In all groups, clear demarcation was evident between the trans-plant and host site until first week was passed. However, this line gradually became vague and finally at the end of 8th week totally indistinguishable.
3) In all cases, hemorrhage and round cell infiltrations were evident surrounding transplants one week subsequent to the operation. However, at this stage no trend of either resofption or bone apposition was observed in or around the transplants. Specimen prepared towards the end of the experiments clearly manifested the evidence of the resorption of transplant and formation of new bone from the host site.
Generally impressions from this experiment was that the formation of new bone seemed more active in the cold-stored hornografting group rather than the other two groups.

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