背景:自从牵张成骨进入颌面外科以来,牵张器决定着牵张成骨的发展,突破直线牵张成骨的关键在于设计三维牵张器.目的:对颧骨外固定三维牵张器的设计和制作进行探讨.设计:研制一种新型外置式三维牵张器,进行羊颧骨三维牵张成骨实验.单位:安徽医科大学第一附属医院口腔科.材料:牵张器均为组织相容性好的生物材料钛制成,该牵张器包括支撑、牵张、变向3部分,另外,还有钛垫片、扳手、橡皮垫等配件.方法:10月龄羊,将离体羊头处理后制备离体羊颧骨标本,羊颧骨大体形状呈弧形,由一体四突构成,大体形状结构和骨连接与人颧骨相似.根据机械移动原理,设计两块可相对移动的支撑板,一定范围内在两个垂直方向任意移动,带动牵张杆改变牵张方向,进行三维牵张成骨,在离体羊颅骨模型上进行模拟牵张成骨.主要观察指标:在牵张杆的作用下,牵张板在三维方向移动以及牵张器整体稳定情况.结果:自行研制的三维缝牵张器重量30 g,牵张杆前后向移动2 cm左右,上下方向移动3.5 cm左右,向外移动3 cm左右,牵张控制准确,三维变向简便易行.结论:设计的外固定三维牵张器可以三维牵张,操作简便易行,控制准确.%BACKGROUND: Distractor has decided the development of distraction osteogenesis since it was applied in oral and maxillofacial surgery. How to breach the limit of traditional distraction osteogenesis lies on designing three-dimensional (3-D) distractor.OBJECTIVE: To explore the design and manufacture of 3-D external distractor for zygomatic bone.SETTING: Department of Oral and Maxillofacial Surgery, First Affiliated Hospital of Anhui Medical University.DESIGN: An experiment of the external distraction system for 3-D distraction osteogenesis.MATERIALS: The distractor was made of biological material titanium with well histocompatibility, and consisted of three parts (support, expansion and direction-change) as well as some fittings such as titanium backup plate, spanner and rubber mat, etc.METHODS: Caprine of 10 months old were selected to separate the heads and prepare for isolated zygomatic models. Zygomatic bones were generally curve and made up of four-process-in-one, with the identical formation as human being. According to principle of mechanical movement,two support plates were designed to move relatively, which transferred randomly along with two perpendicular directions. It was done to change the direction and model 3-D distraction osteogenesis on zygomatic bone of the isolated caprine cranium.MAIN OUTCOME MEASURES: 3-D transference of expansion board and whole stabilization of distractor were observed in the process of distraction osteogenesis.RESULTS: The self-prepared 3-D external distractor was 30 g. The lengthener was built to provide 3-D suture expansion osteogenesis by changing the direction. The expansion bar could be moved about 2 cm in anteroposterior axes, 3.5 cm in perpendicular axes, 3 cm in coronal axes.CONCLUSION: The 3-D distractor is simple, accurate and practicable in experimental study, and lays a foundation for clinical study in the future.
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