Department of Oral and Maxillofacial Surgery, Tokyo Medical University, Tokyo, Japan.
Tohoku J Exp Med. 2010 Jan;220(1):67-75. doi: 10.1620/tjem.220.67.
Distraction osteogenesis (DO) is a surgical process of new bone generation through the gradual extension of two segments of existing bone. DO is applied for maxillofacial surgeries to manage defects in mandibular continuity. Vertical DO with an oral device is often employed to augment the alveolar bone height for better implant anchorage for esthetic purposes or functional prosthetic requirements. To determine how the periosteum affects the vertical DO in mandibular reconstruction, we extracted the teeth and resected the alveolar parts of the mandible on both sides of dogs, along with removal of the surrounding periosteum in the right, but not left side. Three months later, box-shaped bone segments (vectors) were prepared from the resected alveolar part, and the segments were vertically elongated using a distraction device on both sides at 0.9 mm/day for one week. The extent of bone formation after distraction was determined with micro-focused computed tomography and by measuring incorporation of tetracycline and calcein with confocal laser scanning microscopy. During the initial two months after distraction, new bone formation was observed more prominently in the left side than in the right side of mandible with the periosteum. However, this difference was less clear during the bone-remodeling period. One notable change was the reduced height of the alveolar part of the right-side mandible, a sign of external bone resorption, observed in two out of three dogs at 6-month post-consolidation. These findings suggest that preservation of periosteum prevents the external bone resorption during the vertical DO of mandible.
牵引成骨术（DO）是一种通过逐渐延长两段现有骨骼来生成新骨的手术过程。DO 应用于颌面外科手术，以管理下颌连续性缺陷。为了获得更好的种植体锚固，以满足美观或功能性修复要求，常采用带口腔装置的垂直 DO 来增加牙槽骨高度。为了确定骨膜如何影响下颌骨重建中的垂直 DO，我们在犬的两侧拔牙并切除下颌骨的牙槽部分，并在右侧而非左侧切除周围的骨膜。三个月后，从切除的牙槽部分制备出盒状骨段（载体），并在两侧使用牵引装置以每天 0.9 毫米的速度进行垂直延长，持续一周。使用微焦点计算机断层扫描和共聚焦激光扫描显微镜测量四环素和钙黄绿素的掺入来确定牵引后的骨形成程度。在牵引后的头两个月，有骨膜的左侧下颌骨的新骨形成比右侧更为明显。然而，在骨重塑期间，这种差异不太明显。在巩固后 6 个月，有两只狗的右侧下颌骨牙槽部分高度降低，这是外部骨吸收的迹象，这是一个值得注意的变化。这些发现表明，保留骨膜可防止在垂直 DO 过程中发生外部骨吸收。
