노령견의 하악골절 불유합 1례에서 골유도재생술의 임상적 효과

Clinical Effect of Guide Bone Regeneration of Mandibular Nonunion in a Geriatric Dog

  • Kim, Se-Eun (College of Veterinary Medicine, Chonnam National University) ;
  • Shim, Kyung-Mi (College of Veterinary Medicine, Chonnam National University) ;
  • Bae, Chun-Sik (College of Veterinary Medicine, Chonnam National University) ;
  • Choi, Seok-Hwa (College of Veterinary Medicine, Chungbuk National University) ;
  • Jeong, Soon-Jeong (School of Dentistry, Chosun University) ;
  • Kang, Seong-Soo (College of Veterinary Medicine, Chonnam National University)
  • 심사 : 2013.04.15
  • 발행 : 2013.04.30

초록

13년령의 4.2 kg 암컷 푸들이 하악의 병적 골절 후 지역병원에서 받은 양측성 하악 수술의 실패로 내원하였다. 수술은 2.0-mm miniplates/screws, 돼지해면질골 및 흡수성 막을 사용해 시행되었다. 수술 후 1일, 1, 4, 8, 12주에 예후를 평가하였다; 치아 부정교합, 골절 불유합, 또는 연부조직 감염의 징후는 보이지 않았다. 그러나 1년 후 장기간 검진에서 콜라겐 막을 사용하지 않았던 왼쪽 하악골절부위에 불유합이 관찰되었다. 따라서 노령견에서 하악골 불유합의 치유에 돼지해면골과 흡수성 막을 함께 사용하는 것은 효과적이라 생각된다.

A 13-year-old, 4.2 kg female poodle was referred for failure of first bilateral mandibular surgery at a local animal hospital after pathologic fracture. Surgery was performed with 2.0-mm miniplates/screws and porcine cancellous bone grafts. In addition, because of the large size of the right segmental defect, a barrier absorbable membrane was employed for guide bone regeneration on right mandible. After surgery, follow-ups performed at 1 day, 1, 4, 8, and 12 weeks; there were no signs of dental malocclusion, nonunion or soft tissue infection. However, a 1-year long-term follow-up showed nonunion in the left mandibular fracture site for which a collagen membrane had not been used. It is considered that use of porcine bone graft with barrier absorbable membrane may be effective for the repair of mandibular nonunion in a geriatric dog.

키워드

참고문헌

  1. Aichelmann-Reidy ME, Yukna RA. Bone replacement grafts. Dent Clin North Am 1998; 42: 491-503.
  2. Bunyaratavej P, Wang HL. Collagen membranes: a review. J Periodontol 2001; 72: 215-229. https://doi.org/10.1902/jop.2001.72.2.215
  3. Coughlan AR, Miller A. The skull and mandible. In: Manual of small animal fracture repair and management. Fordingbridge: BSAVA. 1998: 115-129.
  4. Goldberg VM, Stevenson S. Natural history of autografts and allografts. Clin Orthop Relat Res 1987; 225: 7-16.
  5. Gosain AK, Persing JA. Biomaterials in the face: benefits and risks. J Craniofac Surg 1999; 10: 404-414. https://doi.org/10.1097/00001665-199909000-00006
  6. Gruss JS, Phillips JH. Complex facial trauma: The evolving role of rigid fixation and immediate bone graft reconstruction. Clin Plast Surg 1989; 16: 93-104.
  7. Harvey CE, Emily PP. Oral Surgery. In: Small animal dentistry. St. Louis: Mosby-Year Book. 1993: 324-333.
  8. Yoo KH, Kim SE, Shim KM, Park Hj, Choi SH, Kang SS. Effect of porcine cancellous bones on regeneration in rats with calvarial defect. J Life Sci 2010; 20: 1207-1213. https://doi.org/10.5352/JLS.2010.20.8.1207
  9. Slatter DH. Maxillofacial fractures. In: Textbook of small animal surgery, 3rd ed. Philadelphia: WB saunders. 2003: 2194-2206.
  10. Strietzel FP, Khongkhunthian P, Khattiya R, Patchanee P, Reichart PA. Healing pattern of bone defects covered by different membrane types- a histologic study in the porcine mandible. J Biomed Mater Res B Appl Biomater 2006; 78: 35-46.
  11. Umphlet RC, Johnson A. Mandibular fractures in the dog. A retrospective study of 157 cases. Vet Surg 1990; 19: 272-275. https://doi.org/10.1111/j.1532-950X.1990.tb01184.x
  12. Zitzmann NU, Naef R, Schärer P. Resorbable versus nonresorbable membranes in combination with Bio-Oss for guided bone regeneration. Int J Oral Maxillofac Implants 1997; 12: 844-852.