Ｓｅｇｍｅｎｔａｌ ｍａｘｉｌｌａｒｙ ｓｕｒｇｅｒｙ後の血管再生および骨性治ゆに関する実験的研究

Abstract

Vascular iscemia secondary to soft tissue flap design, streching of the nutrient pedicles, segmentation and transection of the descending palatine vessels have been implicated as causative factors of osteonecrosis after total maxillary osteotomy. To examine the combined effects of all these factors on wound healing, 4-segment maxillary osteotomies with 7-40mm advancements and transection of the descending palatine vessels were performed on 6 male adult Rhesus monkeys through buccal tunneling incisions and palatal flaps. Post operative revascularization and bone healing were evaluated by microangiographic and histologic methods. Despite early transient ischemia, labio-buccal gingiva and mucosa and palatal mucosa provided sufficient nutrient pedicles for segmental maxillary osteotomies snd advancement accomplished through a dual access technique to the buccal and palatal areas. Transection of the descending palatin vessels and stretching of the vascular pedicles had no discernible effect on revascularization and bone healing with this procedure.