The Study About The Curative Effect And The Osteogeesis In The Process Of Bone Defect Repair Using The Pedicle Fascialflap As The Membrane Material And The GBR Technique

To study the curative effect and the the osteogenesis in the process of the critical size bone defect repair through the comparison of using the uncellular tissue engineering compound wrapped by pedical fascial flap with vessels as the membrane material and simple implantation of uncellular tissue engineering compound, To provide reference in clinical to repair critical size bone defect with the guided bone regeneration technique.50New-zland4-5-month-old rabbits, male or female, weight2.0～2.5kg, were usd to prepare the hibateral periosteum-included bone defect models in the middle piece of the ulna and the length of the defect was2cm. Autologous red bone marrow was implanted in the osteoinductive absorbing material to prepare tissue engineering bone.Implanted the prepared uncellular tissue engineering compound in the bone defect area and the ones whose defects were not wrapped any thing were allocated to Group A while the ones whose defects wrapped by pedical fascial flap with blood supply were allocated to Group B. At the fourth, eighth,twelfth and sixteenth week after the operation each group was provided with four rabbits examined by the radiograph(x-ray), the light density measurement, gross morphology and histological inspection,bone shape measurement analysis in the junctional zone. At the eighth, twelfth and sixteenth week each group was provided with three fresh ulnar backbone to conduct three-point bending mechanical tests by the BOSE3520-AT biomechanical experiments to Determinetion mechanical stiffness. The data was analyzed by statistics to see the difference of the bone defect repair. In addition to one animal in group A exitet the experiment due to wound infection and implant extrusion and be filled by another, the other experimental animals were generally in good condition.4th week; Control group X-ray imaging: implants shows texture clearly, the gap between bone and implants was clearly visible; Experimental group X-ray showed a fuzzy texture of the implant the gap between bone and implants was not obvious, there was little external callus formation; Histologically:Control group, there was border zone fiber connective tissue, and a large number of fibrous connective tissue ingrowth within the implants, there are scattered chondrocytes minimal, and new bone trabeculae. Fascial flap of the experimental group are formated a kind of periosteum which blocked the surrounding soft tissue into the repairing bone defect, a little degradation at and within the implant surrounding, the developing trabecular bone and cartilage cell mass formation scattered around, and no obvious infiltration of lymphocytes.Histomorphometry and mechanical aspects of the experimental group was superior to the control group in the osteogenic area and mechanical strength excellent, showing a significant difference (P <0.05). In8th week; Imaging:implants of the control group were fuzzy texture, the gap between bone and implants was still obvious, no external callus formation; Around the implants of experimental group projective absorbed part of degradation and the implant with ulnar stumpgap disappeared; Histology:the control group, fibrous connective tissue hyperplasia extended significantly to the trabecular structure of the newly formed bone, scattered chondrocytes corporations and foreign body giant cell reacted. The implanted surface of the experimental group was still visible, translucent periosteal tissue wrapped membrane callus formation and wrapped implants, the development of more mature trabecular bone and cartilage tissue formation in the implants could be observed. Histomorphometry and mechanical aspects the experimental group was superior to the control group in strength of the osteoblast and significantly increased compared to the4th week, statistics showed there are significant differences (P<0.05). In12th week; Imaging:external callus formed and the implants were wrapped in the control group; In the experimental group the backbone structure was initially formed of the cortical bone continuoued, part of the canal and then passed; At the junction there was still fibrous connective tissue histology, disordered arrangement of fibrous callus from the surrounding the implant surface, deeper trabecular bone structure was less in control group. Implants were nearly completely degraded, and formed inside and on the surface a large number of mature trabecular bone layered order in good, part of the bone marrow cavity recanalized. Bone histomorphometry and mechanical aspects of the experimental showed mechanical strength of the osteoblast were excellent and significantly increased in the area of the experimental group, the statistics show a significant difference (P<0.05). In16th week, Imaging: the implants of control group degradated little, less new bone regeneration, medullary cavity barrier; Implants completely degraded and the normal backbone structure formed, the bone marrow cavity completely recanalized in the experimental group; Histologically:fibrous connective tissue of the bone ends at the junction of the control group still exised, in the implants there were development of more mature trabecular bone, the bone marrow cavity did not pass. Implants wreckage absorption and completely were replaced by new bone formation of mature bone in the experimental group, the bone marrow cavity recanalized. Bone histomorphometry and mechanical aspects of the experimental showed mechanical strength of the osteoblast were superior and significantly increased in the area the experimental group, comparing with the12th week increased significantly, statistics showed there were significant differences (P<0.05).The conclusion is the pedical fascial flap with vessels can be used in the guided bone regeneration technique. And it has obvious effec in promoting the process of the bone defect repair; Fibrous connective tissue and soft tissue can be obstacled into the bone defect site by the pedical fascial flap with vessels in a relatively stable environment, it has obvious guided bone regeneration characteristics; The combination of the uncellular tissue engineering compound and the pedical fascial flap with vessels can effectively shorten the time of repair bone defects and can significant improved the quality and quantity of osteogenesis.