拔牙伤口骨性愈合过程中微血管形态的变化。

J Shimada
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引用次数: 2

摘要

在扫描电镜下研究了拔牙创面骨性愈合过程中血管形态的连续变化。取日本猴(Macaca fuscata)上四个门牙后,采用塑料注射法制备铸型。拔牙5天后,血管芽从肺泡壁上原有的血管中萌发到血凝块中,并且从这些芽的尖端发现注射的塑料渗漏。拔牙后一周,新形成的血管向窝中心广泛延伸,扩张的血管向窝口弯曲。拔牙两周后,牙槽内填充了厚的、新形成的血管。在窝底,编织骨形成于不规则的血管网络之间,但在窝壁内排列不同。拔牙4周后,窝壁上形成的新骨变厚并转变为板状骨。在其内部,编织骨从眼底升起,血管的厚度减少并向窝中心移动。拔牙5周后,新的骨结构达到窝口的水平,其表面出现浅凹(枢轴),维管束从那里指向窝口。骨重塑的开始见于窝底骨小梁。拔牙6周后,几乎所有眶内都充满了新的小梁,小梁之间有细小的血管网络被整理出来,并与眶缘外的骨膜血管网络相通。拔牙窝间的牙槽间隔因板状骨沉积而增厚,形成松质骨。可以说,在拔牙创面骨愈合的各个阶段所形成的微血管模式有助于编织骨的形成和发展。
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[Changes in the microvascular patterns during the osseous healing of the tooth extraction wounds].

Successive changes in the vascular pattern during the osseous healing of extraction wounds were investigated by studying microvascular casts under a scanning electron microscope. The casts were prepared utilizing the plastic injection method, after the extraction of the upper four incisors of the Japanese monkey (Macaca fuscata). Five days after extraction, vascular buds have sprouted from a pre-existing blood vessel on the alveolar wall into the blood clot, and leakage of the plastic injected was found from the tips of these buds. One week after extraction, newly-formed vessels have extended widely to the socket center, and dilated vessels have arborized towards the socket opening. Two weeks after extraction, the socket was filled with thick, newly-formed vessels. In the socket fundus, the woven bone was formed between irregular vascular networks, but was arranged different in the socket wall. Four weeks after extraction, the new bone forming on the socket wall became thickened and converted to a lamella-like bone. Inside it the woven bone was raised from the fundus, and blood vessels leaving it were decreased in their thickness and passed toward the socket center. Five weeks after extraction, the new bone structures came up to the level of the socket opening, the surface of which appeared as a shallow concavity (pivot), from which vascular bundles were directed to the socket opening. A beginning of the bone-remodeling was seen in osseous trabeculae in the socket fundus. Six weeks after extraction, almost all of the socket became filled with new trabeculae, between which, fine vascular networks were sorted out and communicated with the periosteal vascular network beyond the socket margin. The interalveolar septum between the extraction sockets was thickened by deposition of the lamella-like bone to be remodeled to a cancellous bone. It can be said that microvascular patterns formed through all stages of the osseous healing of the extraction wounds contributed to a woven bone formation and its development.

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