THE EFFECT OF REPETITIVE DISTRACTION AND COMPRESSION ON NEW BONE FORMATION DURING DISTRACTION

골신장술시 반복적인 압축과 신장 방법이 골형성에 미치는 영향

  • Yoon, Byung-Wook (Dept. of Oral and Maxillofacial Surgery, Kyung-Hee University Dental School) ;
  • Kim, Yeo-Gab (Dept. of Oral and Maxillofacial Surgery, Kyung-Hee University Dental School) ;
  • Oh, Jung-Hwan (Dept. of Oral and Maxillofacial Surgery, Kyung-Hee University Dental School)
  • 윤병욱 (경희대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 김여갑 (경희대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 오정환 (경희대학교 치의학전문대학원 구강악안면외과학교실)
  • Published : 2008.09.30

Abstract

Purpose: The aim of the present study is to evaluate the effect of repetitive distraction and compression on new bone formation during distraction period. Materials and methods: Sixteen healthy rabbits, weighing about 2.5kg, were used in this experiment. A unilateral mandibular osteotomy was performed in the left mandible and the distractor(Track 1 $plus^{(R)}$, Gebruder Martin $GmbH^{(R)}$, Germany) was fixed with four screws (Cross driver screw $TI^{(R)}$, Gebruder Martin $GmbH^{(R)}$, Germany). After 4 days, the mandibles were distracted at a rate of 0.6mm/day for 10 days to obtain the amount of 6mm distraction in the control group(n=4). In the experimental group A(n=6), they were distracted at a rate of 1.2mm/day for 5 days and then compression of 0.6mm length and distraction of 0.6mm per 12 hours were carried out as counter direction for 5 days, relatively. In the experimental group B(n=6), distraction of 1.2mm length and compression of 0.6mm length per 12 hours were repeated for 10 days to obtain the amount of 6mm distraction finally. The experimental animals were sacrificed at 2 and 4 weeks after surgery and block specimens were obtained. With histologic and histomorphometric analysis, we observed the histologic changes of the cells and bone formation after H-E and Masson- Trichrome staining and then, measured Bone Deposition Rate with TOMORO $ScopeEye^{TM}$ ver. 3.5(Olympus, Japan), Results: Histologically, new bone formation was examined in all experimental groups and the control. But, the ability of bone formation of the experimental group A was somewhat better than any other groups. On the histomorphometric analysis, Bone Deposition Rate was higher in the experimental group A$(50.67{\pm}4.36%)$ than in the control group$(45.94{\pm}3.97%)$ and in the experimental group B$(42.68{\pm}5.70%)$. These data showed significant differences statistically(p<0.05). Conclusion: These results show that the distraction osteogenesis using repetitive compression and distraction force in the early consolidation period may be effective for new bone formation.

Keywords

References

  1. Ayoub AF, Richardson W, Koppel D et al : Segmental mandibular reconstruction by microincremental automatic distraction osteogenesis: an animal study. Br J Oral Maxillofac Surg 39 : 356, 2001 https://doi.org/10.1054/bjom.2001.0658
  2. Kitoh H, Kitakoji T, Tsuchiya H et al : Transplantation of culture expanded bone marrow cells and platelet rich plasma in distraction osteogenesis of the long bones. Bone 40 : 522, 2007 https://doi.org/10.1016/j.bone.2006.09.019
  3. Okazaki H, Kurokawa T, Nakamura K et al : Stimulation of bone formation by recombinant fibroblast growth factor- 2 in callotasis bone lengthening of rabbits. Calcif Tissue Int 64 : 542, 1999 https://doi.org/10.1007/s002239900646
  4. Nakamura K, Kawaguchi H, Aoyama I et al : Stimulation of bone formation by intraosseous application of recombinant basic fibroblast growth factor in normal and ovariectomized rabbits. J Orthop Res 15 : 307, 1997 https://doi.org/10.1002/jor.1100150222
  5. Tsubota S, Tsuchiya H, Shinokawa Y et al : Transplantation of osteoblast-like cells to the distracted callus in rabbits. J Bone Joint Surg Br 81 : 125, 1999 https://doi.org/10.1302/0301-620X.81B1.9018
  6. Kokoroghiannis C, Papaioannou N, Lyritis G et al : Calcitonin administration in a rabbit distraction osteogenesis model. Clin Orthop Relat Res 415 : 286, 2003 https://doi.org/10.1097/01.blo.0000092966.12414.05
  7. Pampu AA, Dolanmaz D, Tuz HH et al : Experimental evaluation of the effects of zoledronic acid on regenerate bone formation and osteoporosis in mandibular distraction osteogenesis. J Oral Maxillofac Surg 64 : 1232, 2006 https://doi.org/10.1016/j.joms.2006.04.038
  8. Farhadieh RD, Dickinson R, Yu Y et al : The role of transforming growth factor-beta, insulin-like growth factor I, and basic fibroblast growth factor in distraction osteogenesis of the mandible. J Craniofac Surg 10 : 80, 1999 https://doi.org/10.1097/00001665-199901000-00016
  9. Fredericks DC, Piehl DJ, Baker JT et al : Effects of pulsed electromagnetic field stimulation on distraction osteogenesis in the rabbit tibial leg lengthening model. J Pediatr Orthop 23 : 478, 2003 https://doi.org/10.1097/00004694-200307000-00012
  10. Uglow MG, Peat RA, Hile MS et al : Low-intensity ultrasound stimulation in distraction osteogenesis in rabbits. Clin Orthop Relat Res 417 : 303, 2003
  11. Narasaki K, Shimizu H, Beppu M et al : Effect of extracorporeal shock waves on callus formation during bone lengthening. J Orthop Sci 8 : 474, 2003 https://doi.org/10.1007/s00776-003-0664-4
  12. Hosny G, Shawky MS : The treatment of infected nonunion of the tibia by compression-distraction techniques using the Ilizarov external fixator. Int Orthop 22 : 298, 1998 https://doi.org/10.1007/s002640050264
  13. Stokes IA, Clark KC, Farnum CE et al : Alterations in the growth plate associated with growth modulation by sustained compression or distraction. Bone 41 : 197, 2007 https://doi.org/10.1016/j.bone.2007.04.180
  14. Mofid MM, Inoue N, Atabey A et al : Callus stimulation in distraction osteogenesis. Plast Reconstr Surg 109 : 1621, 2002 https://doi.org/10.1097/00006534-200204150-00020
  15. Kim UK, Chung IK, Lee KH et al : Bone regeneration in mandibular distraction osteogenesis combined with compression stimulation. J Oral Maxillofac Surg 64 : 1498, 2006 https://doi.org/10.1016/j.joms.2006.03.028
  16. Kwon JK, Park HJ, Ryu SY : The effect of oscillating distraction osteogenesis on new bone formation during mendibulat distraction period in rabbits. J Kor Oral Maxillofac Surg 32 : 241, 2006
  17. Kassis B, Glorion C, Tabib W et al : Callus response to micromovement during elongation in the rabbit. J Pediatr Orthop 18 : 586, 1998 https://doi.org/10.1097/00004694-199809000-00005
  18. Greenwald JA, Luchs JS, Mehrara BJ et al : 'Pumping the regenerate': an evaluation of oscillating distraction osteogenesis in the rodent mandible. Ann Plast Surg 44 : 516, 2000 https://doi.org/10.1097/00000637-200044050-00010
  19. 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 Relat Res 239 : 263, 1989
  20. Ilizarov GA : Clinical application of the tension-stress effect for limb lengthening. Clin Orthop Relat Res 250 : 8, 1990
  21. Hollier LH Jr., Higuera S, Stal S et al : Distraction rate and latency: factors in the outcome of pediatric mandibular distraction. Plast Reconstr Surg 117 : 2333, 2006 https://doi.org/10.1097/01.prs.0000219354.16549.c9
  22. White SH, Kenwright J : The timing of distraction of an osteotomy. J Bone Joint Surg Br 72 : 356, 1990
  23. McCarthy JG, Schreiber J, Karp N et al : Lengthening the human mandible by gradual distraction. Plast Reconstr Surg 89 : 1, 1992 https://doi.org/10.1097/00006534-199289010-00001
  24. Lee BS, Jeon JH, Kim YG et al : Le Fort 3 distraction osteogenesis for treatment of midfacial hypoplasia: a case report. J Kor Maxillofac Plast Reconstr Surg 26 : 598, 2004
  25. Takenobu T, Nagano M, Taniike N et al : Mandibular reconstruction using intraoral trifocal bone transport: report of a case. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 103 : 630, 2007 https://doi.org/10.1016/j.tripleo.2006.07.004
  26. Oh JH, Frank L, Zoeller JE : Vertical distraction of alveolar bone for placement of dental implant. J Kor Oral Maxillofac Surg 28 : 326, 2002
  27. Jang GT, Oh JH, Kim YG : Original Articles : Effect of Latency Period And Direction of Distraction on the New Bone Formation During Distraction Osteogenesis. J Kor Maxillofac Plast Reconstr Surg 26 : 511, 2004
  28. Aida T, Yoshioka I, Tominaga K et al : Effects of latency period in a rabbit mandibular distraction osteogenesis. Int J Oral Maxillofac Surg 32 : 54, 2003 https://doi.org/10.1054/ijom.2002.0347
  29. Troulis MJ, Glowacki J, Perrott DH et al : Effects of latency and rate on bone formation in a porcine mandibular distraction model. J Oral Maxillofac Surg 58 : 507, 2000 https://doi.org/10.1016/S0278-2391(00)90012-0
  30. Tavakoli K, Walsh WR, Bonar F et al : The role of latency in mandibular osteodistraction. J Craniomaxillofac Surg 26 : 209, 1998 https://doi.org/10.1016/S1010-5182(98)80016-4
  31. Amaral CM, Di Domizio G, Tiziani V et al : Gradual bone distraction in craniosynostosis. Preliminary results in seven cases. Scand J Plast Reconstr Surg Hand Surg 31 : 25, 1997 https://doi.org/10.3109/02844319709010502
  32. Nash TJ, Howlett CR, Martin C et al : Effect of plateletderived growth factor on tibial osteotomies in rabbits. Bone 15 : 203, 1994 https://doi.org/10.1016/8756-3282(94)90709-9
  33. Yonezawa H, Harada K, Ikebe T et al : Effect of recombinant human bone morphogenetic protein-2 (rhBMP-2) on bone consolidation on distraction osteogenesis: a preliminary study in rabbit mandibles. J Craniomaxillofac Surg 34 : 270, 2006 https://doi.org/10.1016/j.jcms.2006.02.003
  34. De Bastiani G, Aldegheri R, Renzi BL : The treatment of fractures with a dynamic axial fixator. J Bone Joint Surg Br 66 : 538, 1984
  35. Burger EH, Klein-Nulend J, Veldhuijzen JP : Mechanical stress and osteogenesis in vitro. J Bone Miner Res 7 : S397, 1992 https://doi.org/10.1002/jbmr.5650070407
  36. Kershaw CJ, Cunningham JL, Kenwright J : Tibial external fixation, weight bearing, and fracture movement. Clin Orthop Relat Res 293 : 28, 1993
  37. Kim UK, Shin SH, Jung IK et al : Tissue reaction following by combination of distraction and compression force on distraction osteogenesis of the mandible in the rat. J Kor Oral Maxillofac Surg 28 : 103, 2002
  38. Whong YS, Heo Jm Kim UK et al : Mandibular distraction osteogenesis with compression force. J Kor Maxillofac Plast Reconstr Surg 28 : 531, 2006
  39. Davies J, Turner S, Sandy J : Distraction osteogenesis - a review. Br Dent J 185 : 462, 1998 https://doi.org/10.1038/sj.bdj.4809838
  40. Yamaji T, Ando K, Wolf S et al : The effect of micromovement on callus formation. J Orthop Sci 6 : 571, 2001 https://doi.org/10.1007/s007760100014
  41. Aronson J : Temporal and spatial increases in blood flow during distraction osteogenesis. Clin Orthop Relat Res 301 : 124, 1994
  42. Kojimoto H, Yasui N, Goto T et al : Bone lengthening in rabbits by callus distraction. The role of periosteum and endosteum. J Bone Joint Surg Br 70 : 543, 1988