Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
권호 표지

THE EFFECT OF OSCILLATING DISTRACTION OSTEOGENESIS ON NEW BONE FORMATION DURING MANDIBULAR DISTRACTION PERIOD IN RABBITS

가토의 하악골에서 골신장기 동안 반복 골신장술이 골형성에 미치는 효과

  • Kwon, Jun-Kyong (Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University) ;
  • Park, Hong-Ju (Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University) ;
  • Ryu, Sun-Youl (Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University)
  • 권준경 (전남대학교 치의학전문대학원 구강악안면외과학교실, 전남대학교 치의학연구소) ;
  • 박홍주 (전남대학교 치의학전문대학원 구강악안면외과학교실, 전남대학교 치의학연구소) ;
  • 유선열 (전남대학교 치의학전문대학원 구강악안면외과학교실, 전남대학교 치의학연구소)
  • Published : 2006.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose For the reconstruction of craniofacial deformities, the distraction osteogenesis is an useful method which can make new soft tissues as well as new bone. Although the distraction osteogenesis is an effective procedure in quantitative aspects, the new bone formed by this procedure can be coarse in qualitive aspects sometimes. Materials and methods Twelve rabbits, weighing about 2 kg, were included and the prefabricated distraction device were used. After a latency period of 5 days, in the experimental group (n=6), the mandible was distracted at the rate of 1.0 mm/day for 2 days and then compressed with 1.0 mm for the next 3rd day, therefore distracted totally to a length of 1.0 mm for 3 days. This procedure was repeated 5 times and, as a result, the experimental group was distracted to a length of 5.0 mm for 15 days finally. In the control group (n=6), the mandible was distracted totally to a length of 5.0 mm at the rate of 1 mm/day. At 2 weeks and 8 weeks of consolidation in the control group, 3 rabbits in each group were sacrificed and their biopsy specimens from the distracted mandible were taken. Results All animals showed the mandibular elongation clinically and radiographically. Histologically, many blood vessels, osteoblasts and immature bones formed by osteoid deposition were observed in the experimental group at 2 weeks. At 8 weeks, the bony trabeculae were thicker than the ones in the control group and were composed of lamella bones and woven bones in the experimental group. On histomorphometric analysis, the bone deposition area of the distracted site was broader in the experimental group $(273.8{\pm}115.7\;cm^2)$ than the one in the control group $(199.4{\pm}101.4\;cm^2)$. Futhermore, the modified rate of bone deposition area was higher in the experimental group (48${\pm}$20%) than the one in the control group (35${\pm}$18%). However, these data showed no significant differences statistically. Conclusion These results suggest that the distraction osteogenesis by using an alternating distraction/compression protocols is an effective method for increasing new bone formation in distracted areas.

Keywords

References

  1. Tidstrom KD, Keller EE: Reconstruction of mandibular discontinuity with autogenous iliac bone graft: Report of 34 consecutive patients. J Oral Maxillofac Surg 1990;48:336-365 https://doi.org/10.1016/0278-2391(90)90427-4
  2. Markowitz B, Taleisnik A, Calcaterra T, Shaw W: Achieving mandibular continuity with vascular bone flaps: A comparison of primary and secondary reconstruction. J Oral Maxillofac Surg 1994; 52:114-118 https://doi.org/10.1016/0278-2391(94)90390-5
  3. Trauner D, Richard S, Obwegeser A, Hugo L: Surgical correction of mandibular prognathism and retrognathism with consideration of genioplasty. J Oral Surg 1957;10:787-792 https://doi.org/10.1016/0030-4220(57)90105-6
  4. Dal pont G: Retromolar osteotomy for correction of prognathism. J Oral Surg 1961;19:42-47 https://doi.org/10.1016/0030-4220(65)90214-8
  5. Slavkin HC: Molecular biology experimental strategies for craniofacial- oral-dental dysmorphology. Connect Tissue Res 1995;32:233-239 https://doi.org/10.3109/03008209509013728
  6. 백진아: 반안면 왜소증 환자에서의 골신장술. 대한구강악안면외과학회지 2005;31:526-531
  7. 오승환, 민승기, 권경환, 고세욱, 이경석: 하악과두 골절후 발생한 편측성 하악골 형 성부전의 치료로서 복합적 악골 신장술의 임상 증례. 대한구강악안면외과학회지 2004;30:246-250
  8. 신민영, 안준현, 한정환, 신성수, 박양호, 박영주, 박준우, 이건주: 하악골 결손환자에서 수평적 골 신장술과 임플란트 보철수복 : 증례보고. 대한구강악안면외과학회지 2003;29:444-449
  9. Wagner H: Operative lengthening of the femur. Clin Orthop 1978;136:125-142
  10. Codivilla A: On the means of lengthening in the lower limbs, muscles and tissues which are shortened through deformity. Am J Orthop Surg 1905;2:353-359
  11. Snyder CC, Levine GA, Swanson HM, Browne EZ: Mandibular lengthening by gradual distraction; Preliminary report. Plast Reconstr Surg 1973;51:506-508 https://doi.org/10.1097/00006534-197305000-00003
  12. Ilizarov GA: The tension-stress effect on the genesis and growth of tissues. Part I. The influence of stability of fixation and soft-tissue preservation. Clin Orthop 1989;238:249-281
  13. Ilizarov GA: The tension-stress effect on the genesis and growth of tissues: Part II. The influence of the rate and frequency of distraction. Clin Orthop 1989;239:263-285
  14. McCarthy JG, Schreiber J, Karp N, Thorne CH, Grayson Bh: Lengthening the human mandible by gradual distraction. Plast Reconstr Surg 1992;89:1-10 https://doi.org/10.1097/00006534-199289010-00001
  15. Lines PA: Adult rapid maxillary expansion with corticotomy. Am J Orthod 1975;67:44-56 https://doi.org/10.1016/0002-9416(75)90128-1
  16. Bell WH, Jacobs JD: Surgical-orthodontic correction of horizontal maxillary deficiency. J Oral Surg 1979;37:897-902
  17. Block MS, Otten J, McLaurin D, Zoldos J: Bifocal distraction osteogenesis for mandibular defect healing: Case report. J Oral Maxillofac Surg 1996;54:1365-1370 https://doi.org/10.1016/S0278-2391(96)90499-1
  18. Chin M, Toth BA: Distraction osteogenesis in maxillofacial surgery using internal devices: review of five cases. J Oral Maxillofac Surg 1996;54:45-53 https://doi.org/10.1016/S0278-2391(96)90303-1
  19. Polley JW, Figueroa AA, Charbel FT, Berkowitz R, Reisberg D, Cohen M: Monobloc craniomaxillofacial distraction osteogenesis in a newborn with severe craniofacial synostosis: a preliminary report. J Craniofac Surg. 1995;6(5):421-423 https://doi.org/10.1097/00001665-199509000-00022
  20. 김용하, 강무석, 김정철, 우상현, 설정현, 변우목: 가토의 하악골 신장시 Sodium fluoride 투여가 골형성에 미치는 영향. 대한성형외과학회지 1999;107:538-545
  21. Robiony M, Polini F, Politi M: Osteogenesis distraction and platelet-rich plasma for bone restoration of the severely atrophic mandible. J Oral Maxillofac Surg 2002;60:630-635 https://doi.org/10.1053/joms.2002.33107
  22. Kokoroghiannis C, Papaioannou N, Lyritis G, Katsiri M, Kalogera P: Calcitonin administration in a rabbit distraction osteogenesis model. Clin Orthop 2003;415:286-292 https://doi.org/10.1097/01.blo.0000092966.12414.05
  23. Mofid MM, Inoue N, Atabey A, Marti G, Edmund YS, Manson PN, VanderKolk CA: Callus stimulation in distraction osteogenesis. Plast Reconstr Surg 2002;109:1621-1629 https://doi.org/10.1097/00006534-200204150-00020
  24. Greenwald JA, Luchs JS, Mehrara BJ, Spector JA, Mackool RJ, McCarthy JG, Longaker MT: An evaluation of oscillation distraction osteogenesis in the rodent mandible. Ann Plast Surg 2000;44:516- 521 https://doi.org/10.1097/00000637-200044050-00010
  25. Luhr HG: On the stable osteosynthesis in mandibular fractures. Dtsch Zahnarztl Z 1968;23:754
  26. Izadi K, Yellon R, Mandell DL, Smith M, Song SY, Bidic S, Bradley JP: Correction of upper airway obstruction in the newborn with internal mandibular distraction osteogenesis. J Craniofac Surg 2003; 14:493-499 https://doi.org/10.1097/00001665-200307000-00019
  27. Shvykov NB, Shamasudinov AH, Sumarokove DD, Shvyrkova II: Non-free osteoplasty of the mandible in maxillofacial gunshot wounds: mandibular reconstruction by compression-osteodistraction. Br J Oral Maxillofac Surg 1999;37:261-267 https://doi.org/10.1054/bjom.1999.0120
  28. Ayoub AF, Richardson W, Koppel D: Segmental mandibular reconstruction by microincremental automatic distraction osteogenesis: an animal study. Br J Oral Maxillofac Surg 2001;39:356-364 https://doi.org/10.1054/bjom.2001.0658
  29. Molina F, Monasterio FO: Mandibular elongation and remodeling by distraction: A farewell to major osteotomies. Plast Reconstr Surg 1995;96:825-840 https://doi.org/10.1097/00006534-199509001-00010
  30. Rachmiel A, Levy M, Laufer DL: Lengthening of the mandible by distraction osteogenesis: report of cases. J Oral Maxillofac Surg 1995;53:838-846 https://doi.org/10.1016/0278-2391(95)90346-1
  31. Davies J, Turner S, Sandy JR: Distraction osteogenesis - a review. Br Dent J 1998;185:462-467 https://doi.org/10.1038/sj.bdj.4809838
  32. Siciliano S, Lengele B, Reychler H: Distraction osteogenesis of a fibular free flap used for mandibular reconstruction; preliminary report. J Craniomaxillofac Surg 1998;26:386-390 https://doi.org/10.1016/S1010-5182(98)80072-3
  33. Swennen G, Schliephake H, Dempf R, Schierle H, Malevez C: Craniofacial distraction osteogenesis; a review of the literature. Int J Oral Maxillofac Surg 2001;30:89-103 https://doi.org/10.1054/ijom.2000.0033
  34. Zimmermann CE, Harris G, Thurmuller P, Troulis MJ, Perrott DH, Rahn B, Kaban LB: Assessment of bone formation in a porcine mandibular distraction wound by computed tomography. Int J Oral Maxillofac Surg 2004;33:569-574 https://doi.org/10.1016/j.ijom.2004.01.022