Bone Regeneration in Mandibular Distraction Osteogenesis Combined With Compression Stimulation

Kim, Uk-Kyu; Chung, In-Kyo; Lee, Kwang-Ho; Swift, James Q.; Seong, Wook-Jin; Ko, Ching-Chang

doi:10.1016/j.joms.2006.03.028

« Previous Next »Journal of Oral and Maxillofacial Surgery
Volume 64, Issue 10 , Pages 1498-1505, October 2006

Bone Regeneration in Mandibular Distraction Osteogenesis Combined With Compression Stimulation

This study was presented at the 84th Annual Meeting of American Association of Oral and Maxillofacial Surgeons, 2002, Chicago, IL.

Uk-Kyu Kim, DDS, PhD
- Associate Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Busan, South Korea.
- Address correspondence and reprint requests to Dr Kim: Department of Oral and Maxillofacial Surgery, Pusan National University Hospital, Amidong 1-10, Seogu, Busan, South Korea
In-Kyo Chung, DDS, PhD
- Professor and Chair, Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Busan, South Korea.
Kwang-Ho Lee, DDS, MS
- Resident, Department of Oral and Maxillofacial Surgery, Dong-A University Medical Center, Busan, South Korea.
James Q. Swift, DDS
- Professor and Director, Division of Oral and Maxillofacial Surgery, Department of Oral Diagnostic & Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN.
Wook-Jin Seong, DDS, MS
- Associate Clinical Specialist, Division of Prosthodontics, Department of Restorative Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN.
Ching-Chang Ko, DDS, PhD
- Assistant Professor, Department of Oral Science, Minnesota Dental Research Center, School of Dentistry, University of Minnesota, Minneapolis, MN.

Purpose

This study compared modified distraction osteogenesis (DO) protocol with conventional DO protocol on healing bone formation. Computer simulation was performed to understand the mechanical environment of modified DO protocol, which applies compression during the consolidation period.

Materials and Methods

Fifty rats were used in this study. Twenty-five rats in the conventional DO (control) group were sacrificed at postoperative days 11, 21, 28, 35, and 49 after osteotomy. In the modified DO (experimental) group, compression was applied on day 7 after distraction (day 18 postoperatively) for 4 days during the early consolidation period and 25 rats were sacrificed on postoperative day 19, 28, 39, 46, and 53. The histologic and radiographic findings were used to compare the 2 groups. Further, computer simulation was used to predict the mechanical environment of healing bone under conventional and modified DO protocol.

Results

Radiographic findings showed that the experimental group resulted in denser and wider healing bone. Histologically, the experimental group yielded more mature lamellar bone than the control group. Computer simulation showed that absolute values of tissue strains were nearly double in the control group because of the softer healing tissues. Both the experimental and control groups showed high strains at the ridge crest. Concentrated tensile strain along the distraction direction at the ridge crest might hinder bone formation at the interface, while compressive strain could facilitate the process.

Conclusion

This study proposed a modified DO protocol of adding compression during the early consolidation period of conventional DO protocol. This new technique appears to provide faster and denser bone regeneration.