Development of Osseointegration Method during Sagittal Split Ramus Osteotomy of the Mandible using poly-L-Lactide Screw Mixed with Bone Morphogenetic Protein

聚左旋丙交酯螺钉与骨形态发生蛋白混合下颌升支矢状劈开截骨术中骨整合方法的开发

• 批准号: 06671995
• 负责人: HARADA Kiyoshi
• 金额: $ 1.41万
• 依托单位: Tokyo Medical & Dental University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (C)
• 财政年份: 1994
• 资助国家: 日本
• 起止时间: 1994 至 1995
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-06671995/
• 关键词: Bone Morphogenetic Protein (BMP); Poly-L-Lactic Acid (PLLA) Screw; Dento-Facial Deformity; Sagittal Split Ramus Osteotomy; Bone Fixation (Osseointegration)

I,Establishment of the method for Poly-L-Lactic Acid (PLLA) Screw Fixation during Sagittal Split Ramus Osteotomy of the Mandible : The physical strength of PLLA-screw is much lower than that of Titanium-screw. Therefore, the method for PLLA screw fixation was established by use of A-O plate screw, custom-made screw-tap and driver. II,Postoperative Changes of the Dento-Facial Deformity Cases Fixed with PLLA Screws : The number of the cases fixed with PLLA screws was 10. Their relapse-tendency was larger than that of the cases fixed with titanium-screws although statistical analysis showed no significant difference. It may be one cause of this tendency that the physical strength of PLLA-screw is lower than that of titanium-one. Therefore, it might be necessary to select the indication of PLLA-screw fixation. III,Development of Bone Morphogenetic Protein (BMP)-PLLA Complex : In this study, the most effective BMP-PLLA complex was made by the mixing in an ultrasonic cleaner in dioxane-solution and freeze-drying. IV,Development of BMP-PLLA Complex Screw and Program of the Future Study : It is very difficult to develop a material which has enough strength for bone fixation and effective dilivery nature for BMP because the harder the material is, the lower the dissolving speed of the factors stored in the material is. Therefore, we have some plans in the program of the future study that bone fixation is done by hard PLLA-materials without BMP and bone steps or gaps is filled by BMP-PLLA complex which has low physical strength.

一、下颌骨升支上裂截骨术中聚乳酸螺钉固定方法的建立：聚乳酸螺钉的物理强度远低于钛螺钉。因此，采用A-O型钢板螺钉、定制丝攻和螺丝刀，建立了PLLA螺钉固定方法。二、PLLA螺钉固定牙面畸形病例术后变化：PLLA螺钉固定病例10例。经统计学分析无显著性差异，但其复发倾向大于钛钉固定组。PLLA螺钉的物理强度低于钛螺钉可能是造成这种倾向的原因之一。因此，可能有必要选择PLLA螺钉固定的适应症。骨形态发生蛋白（BMP）-聚乳酸复合物的研制：在本研究中，最有效的BMP-聚乳酸复合物是通过在超声清洗器中在二氧六环溶液中混合并冷冻干燥而制成的。四、BMP-PLLA复合螺钉的研制及今后的研究计划：由于材料越硬，材料中储存的因子溶解速度就越慢，因此很难研制出既具有足够的骨固定强度，又能对BMP有效吸附的材料。因此，我们在未来的研究计划中有一些计划，即用不含BMP的硬PLLA材料进行骨固定，用低物理强度的BMP-PLLA复合物填充骨台阶或间隙。

项目成果

Kiyoshi Harada: "Stability after Surgical Correction of Mandibular Prognathisms using Sagittal Split Ramus Osteotomy and Fixation with Poly-L-Lactic Acid (PLLA) Screws." Jowrnal of Oral & Maxillofacial Surgery.(submitted).

Kiyoshi Harada：“使用矢状裂支截骨术和聚左旋乳酸 (PLLA) 螺钉固定手术矫正下颌前突后的稳定性。”

Kiyoshi Harada, Shoji Enomoto: "Stability after Surgical Correction of Mandibular Prognathisms using Sagittal Split Ramus Osteotomy and Fixation with Poly-L-Lactic Acid (PLL) Screws." Journal of Oral & Maxillofacial Surgery. (submitted).

Kiyoshi Harada、Shoji Enomoto：“使用矢状裂支截骨术和聚左旋乳酸 (PLL) 螺钉固定来手术矫正下颌前突后的稳定性。”

Takashi Miki: "Effect of Freeze-Dried Poly-L-Lactic Acid (FDPLLA) Discs Mixed With Bone Morphogenetic Protein llealing of Rat Skull Defects." Journal of Oral & Maxillofacial Surgery. 52. 387-391 (1994)

Takashi Miki：“冻干聚左旋乳酸 (FDPLLA) 圆盘与骨形态发生蛋白混合对大鼠颅骨缺损的影响。”

Takashi Miki, kiyoshi Harada, Yohji Imai, Shoji Enomoto: "Effect of Freeze-Dried Poly-L-Lactic Acid (FDPLLA) Discs Mixed with Bone Morphogenetic Protein on Healing of Rat Skull Defects." Journal of Oral & Maxillofacial Surgery. Vol.52. 387-391 (1994)

Takashi Miki、kiyoshi Harada、Yohji Imai、Shoji Enomoto：“冻干聚 L-乳酸 (FDPLLA) 圆盘与骨形态发生蛋白混合对大鼠颅骨缺损愈合的影响”。