Alteration in Volumetric Bone Mineralization Density Gradation Patterns in Mandibular Distraction Osteogenesis following Radiation Therapy
Alteration in Volumetric Bone Mineralization Density Gradation Patterns in Mandibular Distraction Osteogenesis following Radiation Therapy
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DOI：
10.1097/prs.0b013e3181b5a42f
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发表时间：
2009-10-01
影响因子：
3.6
通讯作者：
Buchman, Steven R.
中科院分区：
文献类型：
--
作者：
Fregene, Alero;Jing, Xi Lin;Buchman, Steven R.
背景资料：下颌骨牵引成骨用于肿瘤切除后的组织替换或继发于放疗的变形可能具有巨大的治疗效果。然而，放射治疗严重损害骨愈合，可能排除使用下颌骨牵引成骨作为一个持久的重建选择。作者先前已经证明了36戈伊后下颌骨牵张成骨再生的机械和组织学指标显著降低。作者的目标是现在调查的影响，这些相同的辐射剂量对骨密度使用微型计算机断层扫描scanning.Methods：6 Sprague-Dawley大鼠接受36-戈伊分割放射治疗会话的左下颌骨; 6个没有收到。所有动物均放置外固定器，进行截骨、牵引和巩固。下颌骨进行显微计算机断层扫描。体积密度和显微密度测量进行了analysed.Results：有一个显着的差异，体积骨矿化模式在照射动物。骨体积分数和骨密度，然而，没有表现出显着difficulties.Conclusions：作者发现了一个显着增加低矿化，未成熟骨和显着减少高矿化，成熟骨在照射再生。这些发现证实了作者的假设，即辐射诱导细胞功能下降，损害最佳骨再生。然而，尽管记录了生物力学和组织学指标的显著变化，但根据显微计算机断层扫描测量，总体密度测定没有变化。现在必须寻求一个最佳的辐射剂量，在所有三个结果中显示出更高程度的可再现的降解，但不是不可逆的破坏。这种方法将允许制定旨在增强下颌骨牵张成骨的治疗干预措施，使其可用作可行的重建选择。（Plast。重建124：1237，2009）。
Background: The use of mandibular distraction osteogenesis for tissue replacement after oncologic resection or for deformations secondary to radiotherapy could have immense therapeutic ramifications. Radiotherapy, however, drastically impairs bone healing, potentially precluding the use of mandibular distraction osteogenesis as a durable reconstructive option. The authors have previously demonstrated significantly decreased mechanical and histologic metrics of the mandibular distraction osteogenesis regenerate after 36 Gy. The authors' goal is to now investigate the effect of these same radiation dosages on bone densitometrics using micro-computed tomographic scanning.Methods: Six Sprague-Dawley rats received 36-Gy fractionated radiotherapy sessions to the left mandible; six received none. All animals had external fixators placed, creation of osteotomies, distraction, and consolidation. Mandibles were scanned with micro-computed tomographic scanning. Volumetric density and microdensitometric measurements were analyzed.Results: There was a significant difference in volumetric bone mineralization patterns in irradiated animals. Bone volume fraction and bone mineral density, however, demonstrated no significant differences.Conclusions: The authors discovered a significant increase of low mineralized, immature bone and a significant decrease of highly mineralized, mature bone in the irradiated regenerate. These findings corroborate the authors' hypothesis that radiation induces a diminution in cell function, impairing optimal bone regeneration. Overall densitometrics, however, were unchanged according to micro-computed tomographic measurements, despite documented significant changes in biomechanical and histologic metrics. An optimal radiation dose must now be sought that demonstrates a higher degree of reproducible degradation, but not irreversible destruction, in all three outcomes. Such an approach will allow formulation of therapeutic interventions designed to enhance mandibular distraction osteogenesis so that it may be used as a viable reconstructive option. (Plast. Reconstr. Surg. 124: 1237, 2009.)