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Experimental mandibular regrowth by distraction osteogenesis. Long-term results
P D Costantino1, C D Friedman, M L Shindo
1Department of Otolaryngology-Head and Neck Surgery, Loyola University Stritch School of Medicine, Maywood.
Archives of Otolaryngology--Head & Neck Surgery
|May 1, 1993
Summary
Bifocal distraction osteogenesis successfully regenerated bone in canine mandibular defects, showing stable, functional results after 12 months. This bone regeneration technique shows promise for human mandibular reconstruction.
Area of Science:
- Orthopedic Surgery
- Craniofacial Reconstruction
- Regenerative Medicine
Background:
- Distraction osteogenesis is an accepted orthopedic technique for bone growth.
- Its application to craniofacial skeletal defects is a recent development.
- Previous studies showed short-term success in mandibular defects.
Purpose of the Study:
- To evaluate the long-term (12-month) outcomes of bifocal distraction osteogenesis.
- To assess functional, morphological, and biomechanical results in a canine mandibular defect model.
- To determine the viability of this technique for segmental mandibular reconstruction.
Main Methods:
- Three canines with 2.5-cm unilateral segmental mandibular defects were treated.
- Bifocal distraction osteogenesis was used to fill the defects with regenerate bone.
- Long-term evaluation included functional, macroscopic, histologic, and biomechanical assessments.
Main Results:
- All canines maintained normal oromandibular function for 1 year post-treatment.
- Macroscopic and histologic analysis confirmed re-formation of cortical and medullary bone architecture.
- Regenerated bone exhibited 77% of the strength of normal mandibular bone (53 MPa average ultimate strength).
Conclusions:
- Bifocal distraction osteogenesis provides structurally stable and functional bone regeneration in large mandibular defects.
- The technique demonstrates potential for successful long-term segmental mandibular reconstruction.
- Clinical trials in humans are warranted based on these long-term canine study results.