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Expanded polytetrafluoroethylene entubulation of the rabbit inferior alveolar nerve
1Department of Oral and Maxillofacial Surgery, University of Maryland at Baltimore, MD, USA.
Objective:
The purpose of this study was to evaluate the use of an expanded polytetrafluoroethylene conduit in the treatment of a 6. 0-mm gap in the rabbit inferior alveolar nerve and compare the results with those of an autogenous interpositional tibial nerve graft.
Study Design:
The inferior alveolar nerves of 5 adult New Zealand White female rabbits (10 nerves) were exposed bilaterally, and a 6-mm segment of each nerve was resected. On one side, chosen at random, the gap was immediately bridged through use of an 8.0 x 2. 0-mm expanded polytetrafluoroethylene conduit; on the other side, the gap was grafted with an autogenous tibial nerve graft. Two randomly selected nerves served as sham-dissected controls. At 15 weeks after surgery, the animals were killed and the entire nerve segments were harvested and prepared according to standard fixation and embedding techniques. The sections were examined histomorphometrically to quantify the degree of axonal regeneration through definition of fascicular number, total fascicular surface area, axonal density, and mean axonal diameter at 3 locations along the repair site.
Results:
Light microscopic examination revealed the presence of disorganized neural tissue in both groups, with slightly more fibrovascular interfascicular tissue in the expanded polytetrafluoroethylene group. Histomorphometric analysis revealed no significant differences between groups for most of the measured variables. The mean axonal diameter varied between groups, and the fascicular number was greater in the expanded polytetrafluoroethylene group at the middle site.
Conclusions:
This study demonstrates that regeneration of the inferior alveolar nerve can occur across a 6.0-mm gap through an expanded polytetrafluoroethylene tube with results comparable to those of an autogenous nerve graft, significant donor site morbidity being avoided. The significant differences between groups were probably due to greater containment of regenerating axonal fibers in the expanded polytetrafluoroethylene group.