Low-Level Laser Effect on Mandibular Distraction Osteogenesis
Purpose
The purpose of this study was to determine whether low-level laser (LLL) application during distraction osteogenesis could accelerate bone regeneration and decrease the length of the consolidation phase and thereby reduce potential patient morbidity.
Materials and Methods
Nine adult female New Zealand white rabbits underwent bilateral mandibular corticotomies and placement of unidirectional distraction devices (KLS-Martin LP, Jacksonville, FL). Each rabbit served as its own internal control. After a latency of 1 day, distraction progressed bilaterally at 1 mm per day for 10 days. Immediately after each device activation, the experimental side, chosen randomly, was treated with real LLL (Laser Medical Systems, Hedehusene, Denmark) of 6.0 J × 6 transmucosal sites in the area of the distraction gap. Radiographs were taken presurgically, immediately postsurgically, and weekly until sacrifice, and the bone was analyzed using a semiquantitative 4-point scale (Bone Healing Score [BHS]). Three animals each were sacrificed at 2, 4, and 6 weeks postdistraction, and each hemimandible was prepared for histologic examination in a blinded fashion.
Results
Ten millimeters of distraction was achieved in each rabbit bilaterally. Radiographically, the BHS was higher for the LLL-treated group at all time periods. Histologically, the area of new bone trabeculation and ossification was more advanced for the LLL-treated group, with less intervening fibrovascular intermediate zone in the bony regenerate, at all time periods. The formation of a complete inferior border occurred sooner in the treatment group than in the controls.
Conclusions
LLL accelerates the process of bone regeneration during the consolidation phase after distraction osteogenesis. The adjunctive use of LLL may allow a shortened period of consolidation and therefore permit earlier device removal, with the avoidance of morbidity associated with prolonged device retention.
⁎Leon F. Davis Professor and Section Chief, Residency Program Director, Section of Oral and Maxillofacial Surgery, University of Nebraska Medical Center, Omaha, NE.
†Resident, Plastic and Reconstructive Surgery; Formerly, Resident, Oral and Maxillofacial Surgery, University of Nebraska Medical Center, Omaha, NE.
‡Assistant Professor, Department of Preventive and Societal Medicine, University of Nebraska Medical Center, Omaha, NE.
Address correspondence and reprint requests to Dr Miloro: Section of Oral and Maxillofacial Surgery, 985180 Nebraska Medical Center, Omaha, NE 68198-5180
Supported by an educational grant from KLS-Martin, LP, Jacksonville, FL, and Laser Medical Systems, Hedehusene, Denmark.
ABSTRACT