성견에서 하악재건용 금속판이 하악골 이식재에 끼치는 스트레스 방어 효과에 관한 장기적 연구
STRESS SHIELDING IN MANDIBULAR BONE CRAFTS : A LONG-TERM STUDY IN DOG MODEL
임창준, 김종갑, 이기택,
소속 상세정보
임창준 ( ) - 단국대학교 치과대학 구강악안면외과
김종갑 ( ) - USAF Wilford Hall Medical Center Clinical Investigation Directorate
이기택 ( ) - University of Miami School of Medicine Division of Oral & Maxillofacial Surgery
KMID : 0355619970230030345
Abstract
1. 단단한 금속판이 오랜 기간 부착된 상태로 스트레스를 보호한 정상 하악골 군의 지주
골 밀도는 그런 금속판에 의해 스트레스를 방어 받지 않은 하악골 군의골 밀도에 비해 별
차이를 보이지 않았다.
2. 생활세포성 자가 망상해면골을 이식한 군은 골 이식을 하지 않은 정상 하악골 군에 비
해 지주 골 밀도가 훨씬 더 높게 관찰되었다.
3. 스트레스를 방어 받지 않은 군에서 자가 망상해면골이 이식된 하악골은 다년 간에 걸
쳐서 지주 골 부위에 유의할 만한 골 감소량이 관찰되지 않았다.
4. 생활세포성 자가 망상해면골을 이식한 후에 오랜 기간 금속판이 부착되었던 군은 스트
레스 방어에 의한 영향을 받지 않았으며, 지주 골 부위에 유의할 만한 골 감소량이 관찰되
지 않았다.
이러한 연구 결과들로 미루어 하악골에 있어서 단단한 재건용 금속판에 의한 스트레스 방
어 효과는 특별히 관찰되지 않았다. 따라서 구강악안면외과의사들은 임상에서 단지 금속판
의 스트레스 방어효과를 방지하기 위하여 재건용 금속판을 제거할 필요는 없을 것으로 사료
된다.
#초록#
Sixty mongrel dogs were divided into three groups of twenty dogs. One group of
twenty dogs underwent placement of a rigid reconstruction plate (2.7mm thickness of
plates and 3.0mm diameter of screws, Richards plating system, stainless-steel) and
labeled normal mandibles stress shielded (NMSS) group. Another group of twenty
dogsundeuuent cancellous cellular bone grafts of 3.5cm in length and a rigid
reconstruction plate. In this group the plates were left in place until the time of
sacrifice(1460 days) The group was labeled as a bone grafted mandibles stress shielded
(BGSS). Ten dogs of each group were sacrificed at day 60. Another ten dogs of cach
group were sacrificed at day 1460. In addition, all intitial resection specimens were
processed for histomorphometry on trabecular bone area(TBA) as a normal non-stress
shielded reference value of day-0 control (NMNSS) group.
The histomorphometric results are as follows. Average percentage of TBA at day 0
control in NMNSS group was 44+/-5%. Average percentage of TBA in NMNSS group
at 60 days was 42+/-6% , and that at 1460days was 42+/-4%. Average percentage of
TBA in NMSS group at 60days was 47+/-6%, and that at 1460days was 44+/-4%,
while average percentage of TBA at day 0 control was 44+/-5% (pinot available).
Average percentage of TBA in BGNSS group at 60 days was 67+/-4, and that at 1460
days was 65+/-4%, while average percentage of TBA in day o control was 44+/-5%.
BGNSS group shows, once each mandible was bone grafted at 60 days, that bone
density was increased due to the high cellular bone grains. But after 1460 days there
are little significant change, and that they are stable for four years(p<.001). Average
percentage of TBA in BGSS group at 60 days was O+/-6, and that at 1460 days was
66+/-4% , while average percentage of TBA at day O control was 44+/-5%. BGSS
group with the plate left in place for 4 years also shows the enhanced bone trabecular
percentage at 60 days due to the high cellular bone grafts, but after 60 days until 4
years still little significant change(p<.001).
The result data indicates the stress shielding from the rigid reconstruction plate on
the mandible is not valid. It is suggested that clinicians do not need to remove
reconstruction plates for fear of stress shielding.
키워드
Stress shielding; rigid reconstruction plate; mandible;
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