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Published in: Calcified Tissue International 1/2011

01-07-2011 | Original Research

Three-Dimensional Evaluation of Mandibular Bone Regenerated By Bone Transport Distraction Osteogenesis

Authors: Elias Kontogiorgos, Mohammed E. Elsalanty, Uriel Zapata, Ibrahim Zakhary, William W. Nagy, Paul C. Dechow, Lynne A. Opperman

Published in: Calcified Tissue International | Issue 1/2011

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Abstract

The purpose of this study was to evaluate the structure and material properties of native mandibular bone and those of early regenerate bone, produced by bone transport distraction osteogenesis. Ten adult foxhounds were divided into two groups of five animals each. In all animals, a 3- to 4-cm defect was created on one side of the mandible. A bone transport reconstruction plate, consisting of a reconstruction plate with an attached intraoral transport unit, was utilized to stabilize the mandible and regenerate bone at a rate of 1 mm/day. After the distraction period was finished, the animals were killed at 6 and 12 weeks of consolidation. Micro-computed tomography was used to assess the morphometric and structural indices of regenerate bone and matching bone from the unoperated contralateral side. Significant new bone was formed within the defect in the 6- and 12-week groups. Significant differences (P ≤ 0.05) between mandibular regenerated and native bone were found in regard to bone volume fraction, mineral density, bone surface ratio, trabecular thickness, trabecular separation, and connectivity density, which increased from 12 to 18 weeks of consolidation. We showed that regenerated bone is still mineralizing and that native bone appears denser because of a thick outer layer of cortical bone that is not yet formed in the regenerate. However, the regenerate showed a significantly higher number of thicker trabeculae.
Literature
1.
go back to reference Codivilla A (2008) The classic: on the means of lengthening, in the lower limbs, the muscles and tissues which are shortened through deformity. 1905. Clin Orthop Relat Res 466:2903–2909PubMedCrossRef Codivilla A (2008) The classic: on the means of lengthening, in the lower limbs, the muscles and tissues which are shortened through deformity. 1905. Clin Orthop Relat Res 466:2903–2909PubMedCrossRef
2.
go back to reference Ilizarov GA (1971) Basic principles of transosseous compression and distraction osteosynthesis [in Russian]. Ortop Traumatol Protez 32:7–15 Ilizarov GA (1971) Basic principles of transosseous compression and distraction osteosynthesis [in Russian]. Ortop Traumatol Protez 32:7–15
3.
go back to reference Carls FR, Sailer HF (1998) Seven years clinical experience with mandibular distraction in children. J Craniomaxillofac Surg 26:197–208PubMed Carls FR, Sailer HF (1998) Seven years clinical experience with mandibular distraction in children. J Craniomaxillofac Surg 26:197–208PubMed
4.
go back to reference McCarthy JG, Schreiber J, Karp N, Thorne CH, Grayson BH (1992) Lengthening the human mandible by gradual distraction. Plast Reconstr Surg 89:1–10PubMedCrossRef McCarthy JG, Schreiber J, Karp N, Thorne CH, Grayson BH (1992) Lengthening the human mandible by gradual distraction. Plast Reconstr Surg 89:1–10PubMedCrossRef
5.
go back to reference Molina F, Ortiz Monasterio F (1995) Mandibular elongation and remodeling by distraction: a farewell to major osteotomies. Plast Reconstr Surg 96:825–840PubMedCrossRef Molina F, Ortiz Monasterio F (1995) Mandibular elongation and remodeling by distraction: a farewell to major osteotomies. Plast Reconstr Surg 96:825–840PubMedCrossRef
6.
go back to reference Chiapasco M, Lang NP, Bosshardt DD (2006) Quality and quantity of bone following alveolar distraction osteogenesis in the human mandible. Clin Oral Implants Res 17:394–402PubMedCrossRef Chiapasco M, Lang NP, Bosshardt DD (2006) Quality and quantity of bone following alveolar distraction osteogenesis in the human mandible. Clin Oral Implants Res 17:394–402PubMedCrossRef
7.
go back to reference Chiapasco M, Romeo E, Vogel G (2001) Vertical distraction osteogenesis of edentulous ridges for improvement of oral implant positioning: a clinical report of preliminary results. Int J Oral Maxillofac Implants 16:43–51PubMed Chiapasco M, Romeo E, Vogel G (2001) Vertical distraction osteogenesis of edentulous ridges for improvement of oral implant positioning: a clinical report of preliminary results. Int J Oral Maxillofac Implants 16:43–51PubMed
8.
go back to reference Krenkel C, Grunert I (2009) The Endo-Distractor for preimplant mandibular regeneration. Rev Stomatol Chir Maxillofac 110:17–26PubMedCrossRef Krenkel C, Grunert I (2009) The Endo-Distractor for preimplant mandibular regeneration. Rev Stomatol Chir Maxillofac 110:17–26PubMedCrossRef
9.
go back to reference Elsalanty ME, Taher TN, Zakhary IE, Al-Shahaat OA, Refai M, El-Mekkawi HA (2007) Reconstruction of large mandibular bone and soft-tissue defect using bone transport distraction osteogenesis. J Craniofac Surg 18:1397–1402PubMedCrossRef Elsalanty ME, Taher TN, Zakhary IE, Al-Shahaat OA, Refai M, El-Mekkawi HA (2007) Reconstruction of large mandibular bone and soft-tissue defect using bone transport distraction osteogenesis. J Craniofac Surg 18:1397–1402PubMedCrossRef
10.
go back to reference Herford AS (2004) Use of a plate-guided distraction device for transport distraction osteogenesis of the mandible. J Oral Maxillofac Surg 62:412–420PubMedCrossRef Herford AS (2004) Use of a plate-guided distraction device for transport distraction osteogenesis of the mandible. J Oral Maxillofac Surg 62:412–420PubMedCrossRef
11.
go back to reference Marx RE, Ehler WJ, Peleg M (1996) “Mandibular and facial reconstruction” rehabilitation of the head and neck cancer patient. Bone 19:59S–82SPubMedCrossRef Marx RE, Ehler WJ, Peleg M (1996) “Mandibular and facial reconstruction” rehabilitation of the head and neck cancer patient. Bone 19:59S–82SPubMedCrossRef
13.
go back to reference Kuriloff DB, Sullivan MJ (1991) Mandibular reconstruction using vascularized bone grafts. Otolaryngol Clin North Am 24:1391–1418PubMed Kuriloff DB, Sullivan MJ (1991) Mandibular reconstruction using vascularized bone grafts. Otolaryngol Clin North Am 24:1391–1418PubMed
14.
go back to reference Takushima A, Harii K, Asato H, Nakatsuka T, Kimata Y (2001) Mandibular reconstruction using microvascular free flaps: a statistical analysis of 178 cases. Plast Reconstr Surg 108:1555–1563PubMedCrossRef Takushima A, Harii K, Asato H, Nakatsuka T, Kimata Y (2001) Mandibular reconstruction using microvascular free flaps: a statistical analysis of 178 cases. Plast Reconstr Surg 108:1555–1563PubMedCrossRef
15.
go back to reference Branemark PI, Lindstrom J, Hallen O, Breine U, Jeppson PH, Ohman A (1975) Reconstruction of the defective mandible. Scand J Plast Reconstr Surg 9:116–128PubMedCrossRef Branemark PI, Lindstrom J, Hallen O, Breine U, Jeppson PH, Ohman A (1975) Reconstruction of the defective mandible. Scand J Plast Reconstr Surg 9:116–128PubMedCrossRef
16.
go back to reference Chow JM, Hill JH (1986) Primary mandibular reconstruction using the AO reconstruction plate. Laryngoscope 96:768–773PubMedCrossRef Chow JM, Hill JH (1986) Primary mandibular reconstruction using the AO reconstruction plate. Laryngoscope 96:768–773PubMedCrossRef
17.
go back to reference Marcacci M, Kon E, Zaffagnini S, Giardino R, Rocca M, Corsi A, Benvenuti A, Bianco P, Quarto R, Martin I, Muraglia A, Cancedda R (1999) Reconstruction of extensive long bone defects in sheep using porous hydroxyapatite sponges. Calcif Tissue Int 64:83–90PubMedCrossRef Marcacci M, Kon E, Zaffagnini S, Giardino R, Rocca M, Corsi A, Benvenuti A, Bianco P, Quarto R, Martin I, Muraglia A, Cancedda R (1999) Reconstruction of extensive long bone defects in sheep using porous hydroxyapatite sponges. Calcif Tissue Int 64:83–90PubMedCrossRef
19.
go back to reference Foster RD, Anthony JP, Sharma A, Pogrel MA (1999) Vascularized bone flaps versus nonvascularized bone grafts for mandibular reconstruction: an outcome analysis of primary bony union and endosseous implant success. Head Neck 21:66–71PubMedCrossRef Foster RD, Anthony JP, Sharma A, Pogrel MA (1999) Vascularized bone flaps versus nonvascularized bone grafts for mandibular reconstruction: an outcome analysis of primary bony union and endosseous implant success. Head Neck 21:66–71PubMedCrossRef
20.
go back to reference Pogrel MA, Podlesh S, Anthony JP, Alexander J (1997) A comparison of vascularized and nonvascularized bone grafts for reconstruction of mandibular continuity defects. J Oral Maxillofac Surg 55:1200–1206PubMedCrossRef Pogrel MA, Podlesh S, Anthony JP, Alexander J (1997) A comparison of vascularized and nonvascularized bone grafts for reconstruction of mandibular continuity defects. J Oral Maxillofac Surg 55:1200–1206PubMedCrossRef
21.
go back to reference Barber HD, Seckinger RJ, Hayden RE, Weinstein GS (1995) Evaluation of osseointegration of endosseous implants in radiated, vascularized fibula flaps to the mandible: a pilot study. J Oral Maxillofac Surg 53:640–645PubMedCrossRef Barber HD, Seckinger RJ, Hayden RE, Weinstein GS (1995) Evaluation of osseointegration of endosseous implants in radiated, vascularized fibula flaps to the mandible: a pilot study. J Oral Maxillofac Surg 53:640–645PubMedCrossRef
22.
go back to reference Khatami AH, Toljanic JA, Kleinman A (2010) Mandibular reconstruction with vascularized fibula flap and osseointegrated implants: a clinical report. J Oral Implantol 36:385–390PubMedCrossRef Khatami AH, Toljanic JA, Kleinman A (2010) Mandibular reconstruction with vascularized fibula flap and osseointegrated implants: a clinical report. J Oral Implantol 36:385–390PubMedCrossRef
23.
go back to reference Wei FC, Santamaria E, Chang YM, Chen HC (1997) Mandibular reconstruction with fibular osteoseptocutaneous free flap and simultaneous placement of osseointegrated dental implants. J Craniofac Surg 8:512–521PubMedCrossRef Wei FC, Santamaria E, Chang YM, Chen HC (1997) Mandibular reconstruction with fibular osteoseptocutaneous free flap and simultaneous placement of osseointegrated dental implants. J Craniofac Surg 8:512–521PubMedCrossRef
24.
go back to reference Ahlmann E, Patzakis M, Roidis N, Shepherd L, Holtom P (2002) Comparison of anterior and posterior iliac crest bone grafts in terms of harvest-site morbidity and functional outcomes. J Bone Joint Surg Am 84-A:716–720PubMed Ahlmann E, Patzakis M, Roidis N, Shepherd L, Holtom P (2002) Comparison of anterior and posterior iliac crest bone grafts in terms of harvest-site morbidity and functional outcomes. J Bone Joint Surg Am 84-A:716–720PubMed
25.
go back to reference Holzle F, Kesting MR, Holzle G, Watola A, Loeffelbein DJ, Ervens J, Wolff KD (2007) Clinical outcome and patient satisfaction after mandibular reconstruction with free fibula flaps. Int J Oral Maxillofac Surg 36:802–806PubMedCrossRef Holzle F, Kesting MR, Holzle G, Watola A, Loeffelbein DJ, Ervens J, Wolff KD (2007) Clinical outcome and patient satisfaction after mandibular reconstruction with free fibula flaps. Int J Oral Maxillofac Surg 36:802–806PubMedCrossRef
26.
go back to reference Zijderveld SA, ten Bruggenkate CM, van Den Bergh JP, Schulten EA (2004) Fractures of the iliac crest after split-thickness bone grafting for preprosthetic surgery: report of 3 cases and review of the literature. J Oral Maxillofac Surg 62:781–786PubMedCrossRef Zijderveld SA, ten Bruggenkate CM, van Den Bergh JP, Schulten EA (2004) Fractures of the iliac crest after split-thickness bone grafting for preprosthetic surgery: report of 3 cases and review of the literature. J Oral Maxillofac Surg 62:781–786PubMedCrossRef
27.
go back to reference Elsalanty ME, Zakhary I, Akeel S, Benson B, Mulone T, Triplett GR, Opperman LA (2009) Reconstruction of canine mandibular bone defects using a bone transport reconstruction plate. Ann Plast Surg 63:441–448PubMedCrossRef Elsalanty ME, Zakhary I, Akeel S, Benson B, Mulone T, Triplett GR, Opperman LA (2009) Reconstruction of canine mandibular bone defects using a bone transport reconstruction plate. Ann Plast Surg 63:441–448PubMedCrossRef
28.
go back to reference An YH, Martin KL (2003) Handbook of histology methods for bone and cartilage. Humana Press, Totowa, NJCrossRef An YH, Martin KL (2003) Handbook of histology methods for bone and cartilage. Humana Press, Totowa, NJCrossRef
29.
go back to reference Maniatopoulos C, Rodriguez A, Deporter DA, Melcher AH (1986) An improved method for preparing histological sections of metallic implants. Int J Oral Maxillofac Implants 1:31–37PubMed Maniatopoulos C, Rodriguez A, Deporter DA, Melcher AH (1986) An improved method for preparing histological sections of metallic implants. Int J Oral Maxillofac Implants 1:31–37PubMed
30.
31.
go back to reference Ulrich D, van Rietbergen B, Laib A, Ruegsegger P (1999) The ability of three dimensional structural indices to reflect mechanical aspects of trabecular bone. Bone 25:55–60PubMedCrossRef Ulrich D, van Rietbergen B, Laib A, Ruegsegger P (1999) The ability of three dimensional structural indices to reflect mechanical aspects of trabecular bone. Bone 25:55–60PubMedCrossRef
32.
go back to reference Muller R, Van Campenhout H, Van Damme B, Van Der Perre G, Dequeker J, Hildebrand T, Ruegsegger P (1998) Morphometric analysis of human bone biopsies: a quantitative structural comparison of histological sections and micro-computed tomography. Bone 23:59–66PubMedCrossRef Muller R, Van Campenhout H, Van Damme B, Van Der Perre G, Dequeker J, Hildebrand T, Ruegsegger P (1998) Morphometric analysis of human bone biopsies: a quantitative structural comparison of histological sections and micro-computed tomography. Bone 23:59–66PubMedCrossRef
33.
go back to reference Cope JB, Samchukov ML (2000) Regenerate bone formation and remodeling during mandibular osteodistraction. Angle Orthod 70:99–111PubMed Cope JB, Samchukov ML (2000) Regenerate bone formation and remodeling during mandibular osteodistraction. Angle Orthod 70:99–111PubMed
34.
go back to reference Kabel J, Odgaard A, van Rietbergen B, Huiskes R (1999) Connectivity and the elastic properties of cancellous bone. Bone 24:115–120PubMedCrossRef Kabel J, Odgaard A, van Rietbergen B, Huiskes R (1999) Connectivity and the elastic properties of cancellous bone. Bone 24:115–120PubMedCrossRef
35.
36.
go back to reference Kinney JH, Ladd AJ (1998) The relationship between three-dimensional connectivity and the elastic properties of trabecular bone. J Bone Miner Res 13:839–845PubMedCrossRef Kinney JH, Ladd AJ (1998) The relationship between three-dimensional connectivity and the elastic properties of trabecular bone. J Bone Miner Res 13:839–845PubMedCrossRef
37.
go back to reference Peltonen J (1989) Bone formation and remodeling after symmetric and asymmetric physeal distraction. J Pediatr Orthop 9:191–196PubMed Peltonen J (1989) Bone formation and remodeling after symmetric and asymmetric physeal distraction. J Pediatr Orthop 9:191–196PubMed
38.
go back to reference Vauhkonen M, Peltonen J, Karaharju E, Aalto K, Alitalo I (1990) Collagen synthesis and mineralization in the early phase of distraction bone healing. Bone Miner 10:171–181PubMedCrossRef Vauhkonen M, Peltonen J, Karaharju E, Aalto K, Alitalo I (1990) Collagen synthesis and mineralization in the early phase of distraction bone healing. Bone Miner 10:171–181PubMedCrossRef
39.
go back to reference Kuhn JL, Goldstein SA, Feldkamp LA, Goulet RW, Jesion G (1990) Evaluation of a microcomputed tomography system to study trabecular bone structure. J Orthop Res 8:833–842PubMedCrossRef Kuhn JL, Goldstein SA, Feldkamp LA, Goulet RW, Jesion G (1990) Evaluation of a microcomputed tomography system to study trabecular bone structure. J Orthop Res 8:833–842PubMedCrossRef
40.
go back to reference Feldkamp LA, Goldstein SA, Parfitt AM, Jesion G, Kleerekoper M (1989) The direct examination of three-dimensional bone architecture in vitro by computed tomography. J Bone Miner Res 4:3–11PubMedCrossRef Feldkamp LA, Goldstein SA, Parfitt AM, Jesion G, Kleerekoper M (1989) The direct examination of three-dimensional bone architecture in vitro by computed tomography. J Bone Miner Res 4:3–11PubMedCrossRef
41.
go back to reference Ruegsegger P, Koller B, Muller R (1996) A microtomographic system for the nondestructive evaluation of bone architecture. Calcif Tissue Int 58:24–29PubMedCrossRef Ruegsegger P, Koller B, Muller R (1996) A microtomographic system for the nondestructive evaluation of bone architecture. Calcif Tissue Int 58:24–29PubMedCrossRef
42.
go back to reference Hildebrand T, Ruegsegger P (1997) Quantification of bone microarchitecture with the structure model index. Comput Methods Biomech Biomed Engin 1:15–23PubMedCrossRef Hildebrand T, Ruegsegger P (1997) Quantification of bone microarchitecture with the structure model index. Comput Methods Biomech Biomed Engin 1:15–23PubMedCrossRef
43.
go back to reference Hildebrand T, Laib A, Muller R, Dequeker J, Ruegsegger P (1999) Direct three-dimensional morphometric analysis of human cancellous bone: microstructural data from spine, femur, iliac crest, and calcaneus. J Bone Miner Res 14:1167–1174PubMedCrossRef Hildebrand T, Laib A, Muller R, Dequeker J, Ruegsegger P (1999) Direct three-dimensional morphometric analysis of human cancellous bone: microstructural data from spine, femur, iliac crest, and calcaneus. J Bone Miner Res 14:1167–1174PubMedCrossRef
Metadata
Title
Three-Dimensional Evaluation of Mandibular Bone Regenerated By Bone Transport Distraction Osteogenesis
Authors
Elias Kontogiorgos
Mohammed E. Elsalanty
Uriel Zapata
Ibrahim Zakhary
William W. Nagy
Paul C. Dechow
Lynne A. Opperman
Publication date
01-07-2011
Publisher
Springer-Verlag
Published in
Calcified Tissue International / Issue 1/2011
Print ISSN: 0171-967X
Electronic ISSN: 1432-0827
DOI
https://doi.org/10.1007/s00223-011-9492-2

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