EXPERIPENTAL STUDY OF ROLE OF COMPRESSION FORCES ON DISTRACTION OSTEOGENESIS ON THE RAT MANDIBLE

백서 하악골에서 신연골형성술시 압축력의 효능에 관한 실험적 연구

  • Kang, Hang-Rip (Department of Dentistry, Dong-A University Hospital) ;
  • Kim, Cheol-Hun (Department of Dentistry, Dong-A University Hospital) ;
  • Shin, Sang-Hoon (Oral & Maxillofacial Surerty, Colleage of Dentistry, Pusan National University) ;
  • Chung, In-Kyo (Oral & Maxillofacial Surerty, Colleage of Dentistry, Pusan National University) ;
  • Kim, Uk-Kyu (Oral & Maxillofacial Surerty, Colleage of Dentistry, Pusan National University)
  • 강항립 (동아대학교의료원 치과학교실) ;
  • 김철훈 (동아대학교의료원 치과학교실) ;
  • 신상훈 (부산대학교 치과대학 구강악안면외과학교실) ;
  • 정인교 (부산대학교 치과대학 구강악안면외과학교실) ;
  • 김욱규 (부산대학교 치과대학 구강악안면외과학교실)
  • Published : 2004.10.30

Abstract

Distraction osteogenesis is a biologic process of new bone formation between the surfaces of bone segments that are gradually separated by incremental traction. Distraction osteogenesis is clinically applied as a new treatment modality of mandibular hypoplasia or bony defect area in maxillofacial area by many studies of distraction devices and method. But disadvantage of distraction osteogenesis shows unfavorably long consolidation period and relapse tendency. Therefore. this experiment was designed to investigate the effectiveness of combined application of distraction and compression force for improving of bone quality and shortening of treatment period during distraction osteogenesis. Twenty-one Sprague-Dawley rats with $300{\sim}350gm$ were used. These were divided into two group as distraction group and combination group was applied with compression force in the consolidation period. The rat were sacrificed for gross finding, radiographic and histologic findings. at 2, 4 weeks after distraction. The result were follow : 1. On radiographic finding, all experimental groups appeared more radiopacity than control groups both at 2, 4 weeks after distraction. 2. On histologic finding, trabeculae of bone and mature lamellar bone were showed increasingly in experimental group. Ossification occured rapidly. From this study, we may suggest that compression force application in consolidation period during distraction osteogenesis can be useful method improve bone quality and to shorten the treatment period. But more experimental and clinical studis are necessitated on effects of compression force application during distraction osteogenesis.

Keywords

References

  1. Codivilla A: On the means of lengthening in the lower limbs, the muscles, and tissues which are shortened through deformity. Am J Orthop Surg 2:353, 1905(cited from a reprint of the original article under the title “The Classic”in Clin Orthop 301:4, 1994
  2. Ilizarov GA: The tension-stress effect on the genesis and growth of tissue : Part I The influence of stability of fixation and soft-tissue preservation. Clin Orthop 1989;238:249
  3. Ilizarov GA: The tension-stress effect on the genesis and growth of tissue : Part II The influence of the rate and frequency of distraction. Clin Orthop 1989;239:263
  4. Snyder CC, Levine GA, Swanson HM, et al.: Mandibular lengthening by gradual distraction. Plast Reconstr Surg 1973;51:506
  5. Guerrero CA: Expansion rapida mandibular, Rev Venez Ortod 1990;12:48
  6. McCarthy JG, Schreiber J, Karp N, Thorne CH, Grayson BH: Lengthening of the human mandible by gradual distraction. Plast Reconstr Surg 1992;89:1-10 https://doi.org/10.1097/00006534-199289010-00001
  7. Guerrero CA, Bell WH, Contasti GI, Rodriguez AM: Mandubular widening by intraoral distraction osteogenesis. Br J Oral Maxillofac Surg 1997;35:383-392 https://doi.org/10.1016/S0266-4356(97)90712-9
  8. Diner PA, Kollar EM, Martinez H, Vazquez MP: Submerged intraoral device for mandibular lengthening. J Craniomaxillofac Surg 1997;25:116-123 https://doi.org/10.1016/S1010-5182(97)80002-9
  9. 이광호, 김욱규: 백서 하악골에서 신연골 형성술시 신장력과 수축력 복합적용후의 조직반응. 대한구강악안면외과학회지 2002;28;103-113
  10. Klotch DW, Ganey TM, Slater-Hasse A, et al.: Assessment of bone formation during osteogenesis. A canine model. Otolaryngol Head Neck Surg 1995;112:291
  11. Ilizarov GA: A new principle of osteosynthesis with the use of crossing pins and rings. In Collection of Scientific Works of the Kurgan Regional Scientific Medical Society. Kurgan, USSR, 1954;145-160
  12. Kojimoto H, Yasui N, Goto T, Matsuda S, Shimomura Y: Bone lengthening in rabbits by callus distraction : the role of periosteum and endosteum. J Bone Joint Surg 1989;70-B:543-549
  13. Delloye C, Delefortrie G, Coutelier L, Vincent A: Bone regenerate formation in cortical bone during distraction lengthening. An experimental study. Clin Orthop 1990;250:34-42
  14. Block MS, Cervini D, Chang A, Gottsegen GB: Anterior maxillary advancement using tooth-supported distraction osteogenesis. J Oral Maxillofac Surg 1995;53:561-5650 https://doi.org/10.1016/0278-2391(95)90069-1
  15. Block MS, Brister GD: Use of distraction osteogenesis for maxillary advancement : preliminary results. J Oral Maxillofac Surg 1994;52:282-286 https://doi.org/10.1016/0278-2391(94)90301-8
  16. Costantino PD, Friedman CD: Distraction osteogenesis. Applications for mandibular regrowth. Otolaryngol Clin North Am 1991;24:1433-1443
  17. Karp NS, Thorne CH, McCarthy JG, Sissons HA: Bone lengthening in the craniofacial skeleton. Ann Plast Surg 1990;24:231-237 https://doi.org/10.1097/00000637-199003000-00007
  18. Chin M, Toth BA: Distraction osteogenesis in maxillofacial surgery using internal devices : Review of five cases. J Oral Maxillofac Surg 1996;54:45-53 https://doi.org/10.1016/S0278-2391(96)90303-1
  19. Aronson J, Shen XC, Skinner RA, et al.: Rat model of distraction steogenesis. J Orthop Res 1997;15:221
  20. Rowe NM, Mehrara BJ, Dudziak ME, et al.: Rat mandibular Distraction osteogenesis: Part I. Histologic and radiographic analysis. : Plast Reconstr Surg 1998;102:2022
  21. Babak JM, Norman MR: Rat Mandibular Distraction Osteogenesis: II. Molecular Analysis of Transforming Growth Factor Beta-1 and Osteocalcin Gene Expression. Plast Reconstr Surg 1999;103:536
  22. Warren SM, Mehrara BJ, Steinbrech DS, et al.: Rat mandibular distraction osteogenesis: part III. Gradual distraction versus acute lengthening. Plast Reconstr Surg 2001;107:441
  23. 김부경, 신상훈, 김종렬: 백서 경골에서 신연속도에 따른 골형성 비교 연구. 대한구강악안면외과학회지 2000;26:620-627
  24. Paccione MF, Mehrara BJ, Warren SM, et al.: Rat mandibular distraction osteogenesis: latency, rate, and rhythm determine the adaptive response. J Craniofac Surg 2001;12:175
  25. Yasui N, Sato M, Ochi T, et al.: Three models of ossification during distraction osteogenesis in the rat. J Bone Joint Surg 1997;79(B):824- 830 https://doi.org/10.1302/0301-620X.79B5.7423
  26. Kessler P, Wiltfang J, Neukam FW: A new distraction device to compare continuous and discontinuous bone distraction in mini-pigs : a preliminary report. J Craniomaxillofac Surg 2000;28:5-11 https://doi.org/10.1054/jcms.2000.0101
  27. Wiltfang J, KeBler P, Merten H, Neukam FW: Continuous and intermittant bone distraction using a microhydraulic cylinder : an experimental study in minipigs. Br J Oral Maxillofac Surg 2001;39:2-7 https://doi.org/10.1054/bjom.2000.0564
  28. Fischgrund F, Paley D, Suter C: Variables affecting time to bone healing during limb lengthening. Clin Orthop 301:31-7, 1994
  29. Ilizarov GA: Clinical application of tension-stress effect for limb lengthening. Clin Orthop 1990;250:8
  30. Wolff J: The Law of Bone Remodeling, 1892. P. Marquet and R. Furlong(Trans.). London: Springer-Verlag, 1986
  31. De Bastiani G, Aldegheri R, Renzi Brivio L: The treatment of fractures with a dynamic axial fixator. J Bone Joint Surg(Br) 1984;66:538
  32. Lazo-Zbikowski J, Aguilar F, Mozo F, Gonzalez-Buendia R, Lazo J: Biocompression external fixation sliding external osteosynthesis. Clin Orthop 1986;206:169
  33. Dehne E, Metz CW, Deffer PA, Hall RM: Nonoperative treatment of the fractured tibia by immediate weight bearing. J Trauma 1961;1:514
  34. Burger EH, Klein-Nulend J, Veldhuijzen JP: Mechanical stress and osteogenesis in vitro. J Bone Miner Res Suppl 1992;2:S397
  35. Castello JR, Olaso AS, Chao JJ, et al.: Craniofacial shortening by contraction osteogenesis: An experimental Model. Plast. Reconstr. Surg 2000;105:617
  36. Mofid MM, Inoue N, Atabey A, et al.: Callus stimulation in distraction osteogenesis. Plast Reconstr Surg. 2002 Apr 15;109(5):1621-9 https://doi.org/10.1097/00006534-200204150-00020