下顎骨常因腫瘤，外傷或先天性的缺陷需要做下顎骨截斷性手術，在下顎骨截斷性手術常需要骨移植體 ，而自體移植骨因有骨誘發性 (osteoinduction)，骨傳導性 (osteoconduction)，骨因性(osteogenesity)， 因此常被認為是黃金標準 (golden standard)。在較大的骨缺陷中骨移植體是必要的1，可是在小的截斷性骨缺陷中是否需要骨移植體來改善癒合情形還有待更多的探討。根據最近組織工程的概念，骨膜已被視為骨組織癒合中極適當的骨形成材料2。在骨折或一些截斷性骨缺陷之病例中，骨組織癒合狀況有所差異,可能與骨膜破壞程度有關。一般認為骨膜內層含有間質細胞 ( mesenchymal cell )，而間質細胞可被誘導形成骨母細胞 ( osteoblast)，骨母細胞進而修復骨缺損， 因此骨膜在骨癒合的過程中扮演了重要的角色。為了清楚地瞭解骨膜在對於較小的截斷性骨缺陷的影響，我們設計了本實驗來評估骨膜的潛能以及其對於下顎骨截斷性骨缺陷的影響。
實驗分為體外實驗與動物實驗兩部份：在體外實驗上，我們從老鼠頭蓋骨分離骨膜後培養細胞至第三代，再分別以四種不同之骨性培養液培養14天，再以鹼性磷酸酶做定量與定性之測試。在動物實驗方面，使用八隻大於兩歲檢疫合格的母山羊 (female goat)，體重 47.8~77.9公斤，平均62.9公斤，年齡2歲5個月~4歲6個月，平均 3歲6個月， 隨意分成下顎骨截斷缺陷一公分保留骨膜、下顎骨截斷缺陷一公分去除骨膜、下顎骨截斷缺陷兩公分保留骨膜及下顎骨截斷缺陷去除骨膜等四組，每組各兩隻。首先拔除左側下顎骨第一小臼齒及第二小臼齒，癒合一個月後在全身麻醉下施予下顎骨截斷性手術，癒合期間每隔一個月分別在腹膜施打骨螢光劑作為骨癒合標定，三個月後將羊犧牲，再以放射線影像，電腦斷層影像，組織學觀察2 (光學顯微鏡、螢光顯微鏡)，觀察比較下顎骨癒合情況。
骨膜細胞培養發現，在7天到14 天時，以成骨性培養基培養這組之鹼性磷酸酶/全蛋白質之比值有顯著性變化，顯示骨膜細胞有朝造骨細胞分化之現象發生；無論定性與定量檢測，也是以成骨性培養基培養這組表現最佳。在動物實驗方面，無論放射線影像，電腦斷層影像以及骨量、骨密度之統計，兩公分保留骨膜組之骨癒合情況顯著優於去除骨膜一組。本實驗之結果將可做為後續實驗以及臨床手術之參考。

Under the situation of tumour surgeries, trauma, or deformity in mandibles, segmental defect is sometimes formed. Bone grafts are usually used during reconstruction of the defect especially in larger bone gap or critical size defects1. However, in smaller continuity defects, the use of bone grafts is not required. Based on modern concepts of tissue engineering, periosteum has gained attention as a suitable osteogenic material2. It is postulated that the periosteum has the capability of affecting bone healing in a variety of bone defect. It is vital in bone healing because it contains mesenchymal stem cell which could later differentiate into osteoblast for repairing bone defect. To address the roles of periosteum take in smaller continuity bone defect, a study was conducted to evaluate its potential in this regard. The objective of the study is to determine the involvement of periosteum in bone healing is divided into 2 parts, in vitro and animal study. The in vitro consists of isolation of periosteal cells from rat cranium and the culturing of periosteal cells in different osteogenic medium 14 days. ALPase stain was applied to the cell culture for qualitative observations. The animal study contained eight subjects (goat) weighing 62.9Kg and aged 42 months on average were prepared for the purpose of animal study. They were randomly assigned into 4 test groups differ in length of deformity (1cm and 2cm) and the presence / lack of periosteum on the deformity. The first and second premolar was extracted on the left mandible of all subjects in preparation for segmental surgery. Single injection of Doxycycline and Alizarin-complexon are applied intra-peritoneally as markers of new bone growth. The bone healing rates in each test groups were compared using X-Ray, Computer Tomography (CT), Histopathological Examination, Flurochrome Microscopy, and Statistical Observation (t-test). The in vitro experiment was founded in that there was a dramatic increase in ALPase per total protein indicating differentiation toward osteoblasts by periosteal cells. The effect of dexamethasone in growth medium had been noted to delay or decrease the rate of differentiation and proliferation of periosteal cells to bone forming cells.The animal studies demonstrated that periosteum is a crucial factor in healing of larger bone continuity deformity (2cm) of mandible.

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