Subperiosteal tissue expansion for mandibular augmentation with hydroxylapatite particles: an experimental study

Area of Science:

• Oral and Maxillofacial Surgery
• Biomaterials Science
• Regenerative Medicine

Background:

• Mandibular augmentation is crucial for reconstructive surgery.
• Hydroxylapatite (HA) particles are a viable option for bone grafting.
• Subperiosteal tissue expansion (STE) offers a method to create recipient sites for implants.

Purpose of the Study:

• To evaluate the efficacy of subperiosteal tissue expansion (STE) for mandibular augmentation using hydroxylapatite (HA) particles in a canine model.
• To assess the integration and stability of HA implants within expanded subperiosteal beds.
• To compare outcomes with intact versus decapsulated expanded beds.

Main Methods:

• Bilateral subperiosteal expanded beds were created on the mandibles of dogs.
• Solid HA particles were implanted into these expanded beds.
• Two groups were compared: intact expanded beds and decapsulated expanded beds.

Main Results:

• Marked mandibular augmentation was achieved with HA particles without deformity or infection.
• The fibrous capsule formed by STE facilitated HA particle consolidation and prevented migration.
• Clinical immobilization was achieved within 1-2 months (intact bed) and 2 weeks (decapsulated bed).
• Substantial bone growth into HA implants was observed after 1 year in the intact group.
• Significant mandibular bone resorption was noted in the decapsulated group.

Conclusions:

• Subperiosteal tissue expansion (STE) creates an excellent recipient site for onlayed HA implants in mandibular augmentation.
• The intact subperiosteal expanded bed promotes stable HA implant integration with long-term bone apposition.
• Decapsulation of the expanded bed may lead to undesirable mandibular bone resorption.