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PubMed2002

[Experimental study of the influence of mandibular distraction osteogenesis on inferior alveolar nerve function].

OBJECTIVE: To evaluate the influence of mandibular distraction osteogenesis on inferior alveolar nerve function. METHODS: 16 young Macaca rhesus monkeys were used as experiment animals. 5 days after mandibular osteotomy under general anesthesia, 10 male monkeys were distracted at right side and 6 females were bilaterally distracted at a rate of 0.5 mm x 2/day, for 15 days. The mandible was lengthened to an average of 13.5 mm. The Sensory Nerve Action Potential (SNAP) test was successfully applied in 16 monkeys before operation and at 0, 2, 4, 6, 9 and 12 weeks after distraction finished. Eight-channel EMG equipment was used for SNAP wave recording. The recordings were made with needle electrodes at foramen ovale and the stimulation was done at the mental foramen with two surface electrodes. The metal ground electrode was fixed on the right forearm. The stimulation intensities were five times of thresholds of each animal. The latency was measured at the first wave peak and the amplitude was measured between two wave peaks. RESULTS: Just after distraction finished, the latency period was 22.18% longer than before operation and gradually shortened as time lapsed. When distraction finished, the amplitude of SNAP wave was only 28.54% of that before operation, and after 12 weeks, it increased to the level of 99.84% of that before operation. CONCLUSIONS: The mandibular distraction osteogenesis has temporary influence on the function of inferior alveolar nerve, but it is little and reversible, along with the regeneration of nerve sheath and axon, the nerve function can gradually return to normal level.

Action Potentials↗
PubMed1999

[Comparative study on osteogenesis of three types growth factors recombination artificial bones].

OBJECTIVE: To compare the osteogenesis of recombination artificial bones, which are bovine deproteined bone (bDPB) and bovine bone morphogenetic protein (bBMP), combined with tumor necrosis factor alpha (TNF alpha), basic fibroblast growth factor (bFGF), epidermal growth factor (EGF) respectively. METHODS: One hundred trephined skull bone defects in fifty rabbits were divided into four groups, which implanted with bDPB/bBMP/TNF alpha, bDPB/bBMP/bFGF, bDPB/bBMP/EGF, and bDPB/bBMP respectively. X-ray and histological changes were observed in the 1st, 2nd, 4th, 6th, 8th weeks after implantation. The content of 35S and 45Ca and ash weight were measured at 10 and 42 days after operation. RESULTS: The osteogenesis of bDPB/bBMP/TNF alpha group was stronger than that of bDPB/bBMP/bFGF group(P < 0.01), while bDPB/bBMP/bFGF group was stronger than that of bDPB/bBMP/EGF(P < 0.01). No significant statistical difference were found between bDPB/bBMP/EGF and bDPB/bBMP(P > 0.05). CONCLUSION: TNF alpha combined with bBMP and carrier can stimulate bone formation and increase the volume of new bone in vivo. It suggests that bDPB/bBMP/TNF alpha is a valuable biomaterial of bone graft.

Animals↗
PubMed1999

[Establishment of the animal models of mandibular distraction osteogenesis].

OBJECTIVE: To establish the animal models of mandibular distraction osteogenesis in rabbits and study its osteogenetic mechanism. METHODS: The right mandibles just anterior to the first molars of 12 rabbits were performed osteotomies, and the mandibles were positioned with distractors. The left mandibles were control group without operation. After 1 week, the distractors were stretched 0.9 mm every day for 10 days progressively. One day, 2, 4, 8 weeks after distraction, the mandibles were studied with gross measurement, X-ray, and histological examination. RESULTS: The right mandible were lengthened 8.3 mm on average without bone nonunion and deformity healing. It was observed that the gaps between the distracted bone edges were first occupied by fibrous tissue. Two weeks after distraction, it was found that the gaps were bridged by callus in X-ray, the new bone and the normal bone could not be differentiated clearly after 8 weeks. In histological sections, there were collagen bundles in early distraction, then those collagen bundles were calcificated and become trabeculaes. No Cartilage was found during distraction. CONCLUSION: It suggests that the rabbit mandible can be lengthened by distraction osteogenesis, and the new bone is formed by intramembranous ossification.

Animals↗
PubMed2002

[Distraction osteogenesis for treatment of temporomandibular joint ankylosis].

OBJECTIVE: To study the application of distraction osteogenesis in temporomandibular joint (TMJ) ankylosis patients. METHODS: 11 temporomandibular joint ankylosis patients (13 sides of TMJ) were treated by this technique. After removal of bony mass on the ankylosis area, a L-shape osteotomy of the ramus was performed to create the distraction transport disc which connected the mandible by distractor. Distractions were started on the 4 approximately 8th postoperative day. The distraction rhythm and rate were 0.25 mm 4 times a day. Distraction was stopped when contact was made between the transport disc and glenoid fossa. The patients underwent active mouth opening postoperatively. Distractor was kept in place for 3 approximately 4 months after completion of distraction and then removed under local anesthesia. RESULTS: Postoperatively, the range of mouth opening of the 11 patients (13 sides) was increased to normal (33 approximately 45 mm), bone formation in the gaps were perfect and the neocondyle was remodeling and approximated normal shape. No complications were found. CONCLUSION: Distraction osteogenesis for arthroplasty has many advantages compared with traditional methods. It is valuable in clinical practice as a new method for treatment of TMJ ankylosis.

Adolescent↗
PubMedDate not supplied

The natural limb is best: joint preservation and reconstruction by distraction osteogenesis for high-grade juxta-articular osteosarcomas.

This paper introduces an innovative technique of highly conservative limb-saving surgery for juxta-articular osteosarcoma. This technique consists of marginal tumour excision, joint preservation and reconstruction by distraction osteogenesis. Ten patients, with a mean age of 19.5 years and high-grade osteosarcoma, underwent this procedure. The distal femur and proximal tibia were affected in five patients each. After effective pre-operative chemotherapy, the tumour was excised with preservation of the epiphysis, the articular surface and the maximun amount of healthy soft tissue. This was followed by application of an external fixator. Bone transport was performed for seven patients and shortening-distraction for three. The limb function was rated excellent in seven patients, good in one and fair in two. At the final follow-up, three patients were dead after a mean of 25.3 months while seven patients remained free of disease with a mean follow-up of 55.4 months. Joint preservation and biological reconstruction through distraction osteogenesis can produce excellent and long-lasting functional results.

Bone Neoplasms↗
PubMed2002

Double valve replacement in a patient with osteogenesis imperfecta.

Valvular heart disease (predominantly aortic and mitral valve disease) has been well documented in patients with osteogenesis imperfecta. Twenty-two prior reports of valve replacement and/or repair have been published. Mortality from cardiac surgery in these patients has been high, particularly in those receiving double valve prostheses. Here, a patient is described with advanced cardiovascular disease who underwent successful aortic and mitral valve replacement. This represents the second reported survival of double valve replacement in osteogenesis imperfecta and a reduced mortality rate for this procedure.

Adult↗
PubMed2002

[Update on prenatal diagnosis of osteogenesis imperfecta type II : an index case report diagnosed by ultrasonography in the first trimester].

INTRODUCTION: A case of osteogenesis imperfecta type II diagnosed in the first trimester of pregnancy. DISCUSSION: Lethal osteogenesis imperfecta is a disorder characterized by collagen abnormalities resulting in dwarfism, bone fragility and deformity leading to death in utero or in the perinatal period. Molecular and biochemical studies demonstrate that OI type II results from mutations in either COL1 A1 or COL1 A2 which encode for the chains of type I procollagen. Early diagnosis by US examination in first trimester relies on shortening and bowing of long bones, multiple fractures and hypoechogenicity of the skeleton. When ultrasound examination suspects OI type II, the diagnosis can be accomplished in the first trimester by biochemical analysis if the collagen defect is characterized. CONCLUSION: OI type II results mainly from private mutations and parental mosaicism is an important cause of recurrence making genetic counselling difficult.

Abortion, Therapeutic↗
PubMed2002

[Evaluation of inferior alveolar nerve function with trigeminal somatosensory evoked potential during mandibular distraction osteogenesis in monkeys].

OBJECTIVE: To assess sensory function of inferior alveolar nerve in monkeys with mandibular distraction osteogenesis by use of trigeminal somatosensory evoked potential (TSEP). METHOD: Seven young monkeys, 4 approximately 6 kg, were undergone a 13.5 mm bilateral or right-side mandibular lengthening with mandibular angle osteotomy and intraoral bone-born appliance. The inferior alveolar nerve function was assessed with TSEP before surgery, at the completion of distraction, and after four weeks of fixation. RESULTS: No significant differences in latencies and amplitudes of TSEP between the left and right inferior alveolar nerves before surgery. At the completion of distraction, latencies of TSEP showed significant elongation (P < 0.01, P < 0.001) and amplitudes also significantly decreased (P < 0.001). After four weeks of fixation, various degrees of TSEP recovery were identified. The latencies and the amplitude were slightly improved. CONCLUSIONS: Mandibular distraction osteogenesis affects sensory function of inferior alveolar nerves in studied monkeys evaluated with SEP, but recovery is observed four weeks after surgery.

Alveolar Process↗
PubMed2001

[Growth and osteogenesis characteristics of cultured rat marrow stromal cells under bone induction condition].

OBJECTIVE: To investigate the growth and osteogenesis characteristics of cultured rat marrow stromal cells(rMSCs) under bone induction condition. METHODS: rMSCs were isolated from adult rat using density gradient separation method. The rMSCs attachment formed soon after seeding and grew into colonies with the appearance of fibroblastic cells. The osteogenic induction compound of Dex(10(-8) mol/L), beta-GP(10 mmol/L) and AA(50 micrograms/ml) was added to different passaged rMSCs and the proliferation and osteogenic differentiation of them was observed. RESULTS: The induction compound had strong effect on promoting proliferation, especially on that of further passaged rMSCs, and its stimulation effect on osteogenesis was also well proved with the expression of alkaline phosphatase (ALP) rising after one-week induction. Further subculturing from P1 to P6 led to the increase of proliferation activity of rMSCs. After three-week induction, mineral deposits appeared in the culture. CONCLUSION: The lower expression of ALP in P1 rMSCs and the increase of it in further passages or under induction condition suggest the rMSCs in our culture system are mainly undifferentiated osteoprogenitors.

Alkaline Phosphatase↗
PubMed2002

[A histomorphologic and enzyme histochemical study of masticatory muscles affected by distraction osteogenesis of mandible].

OBJECTIVE: The purpose of this study was to study the masticatory muscles affected by distraction osteogenesis of the mandible. METHODS: The distraction osteogenesis (DO) was applied to distract the left mandible of 6 mongrel dogs that were divided into three experimental groups. After different distraction phase and consolidation phase, the masseter and the digastric muscle were taken out. The specimens were stained using hematoxylin/eosin and enzyme histochemistry. Afterwards, the specimens were observed with a light microscope to study the morphologic changes of the muscles. The contents of enzyme in the different groups were measured by VIDAS. RESULTS: The masseter showed consequently atrophy, but the digastric muscle showed a progress of histomorphologic reconstruction, including atrophy and hypertrophy. The changes of the contents of enzyme and histomorphology were identical in the masticatory muscles. CONCLUSION: The digastric muscle parallel to the vector of mandibular distraction adapts the distraction by the way of atrophy, regeneration and hypertrophy. And the contents of enzyme appear to decrease at the beginning, increase afterwards, and return to the normal level finally. But the masseter perpendicular to the vector of mandibular distraction shows consequent atrophy, and the contents of enzyme consequently decrease, which means the metabolism decrease.

Adenosine Triphosphatases↗
PubMed2000

Bone resorption and/or osteogenesis of the mandible in implanto-orthognathic reconstructive surgery.

Over a period of 18-48 months, the bone resorption, or bone deposition (osteogenesis) of the mandible, in the supero-inferior dimension, was evaluated in patients who had had implanto-orthognathic reconstructive surgery (IORS). It entails the combination of three different types of surgical involvement for the reconstruction of the atrophic (class V), and severely atrophic (class VI) mandibular alveolar ridge (Bütow and Duvenage, 1993). This type of surgical reconstruction combines orthognathic osteotomy, interpositional bone grafting and the immediate placement of osseointegrated implants by means of a trans-mucoperiosteal approach. Evaluation of the mandibular IORS over the long-term, has proven that not only is there minimal resorption, but that osteogenesis of the alveolar ridge occurs.

Adult↗
PubMed2002

[Bone distraction osteogenesis].

Bone osteogenesis has been used by many surgeons to compensate dissymmetry due to congenital malformations, diseases or traumas. Bone distraction is the process of generating new bone in a gap between two bone segments in response to the application of graduated tensile stress across the bone gap. Different types of distraction are actually proposed to be an alternative to facial osteotomies or bone grafting techniques. Distraction can be unilateral, bilateral and correct the deficiencies in one, two or three dimensions. The advantages of the distraction osteogenesis are the possibilities to obtain bone lengthening together with simultaneous expansion of the functional soft tissue matrix including skin, muscles, nerves, cartilage, blood vessels and periosteum. Distractors are internal or external devices made of pins or miniplates fixed on the bone and connected by lengthening--screw--systems allowing elongation.

Adolescent↗
PubMed2003

Correction of shortening and/or angular deformities by distraction osteogenesis using AO-tubular fixator.

Eighteen patients (20 bony segments) who had shortening and/or angular deformities were treated by distraction osteogenesis using AO-tubular external fixator. The mean angular correction was 18.9 degrees (range, 8-40 degrees). Of the group in whom shortening and angulation was corrected, the mean length gained was 4.2 cm (3-6 cm). The mean treatment time was 4.9 months (range, 2-13 months) and the mean follow-up was 12 months after removal of the fixator (range, 3-30 months). Delayed union with loosening of the fixator occurred in one patient which resulted in residual shortening of 1.5 cm. The author's technique of distraction osteogenesis using AO-tubular fixator with the new distraction rate of 1 mm/48 h (1 mm/step) could adequately correct shortening and/or angular deformities. No extra equipment was needed other than the readily-available AO-tubular fixation systems. No serious complications such as neurovascular injury were encountered.

Adolescent↗
PubMed2003

Vascular leak syndrome of Sprague-Dawley rats in a mandibular distraction osteogenesis study.

Vascular leak syndrome (VLS) is a common and often fatal sequela of multiple bone traumas, and of infectious, toxic, and allergic insults in human patients. Although an animal model for VLS has not been fully established, rats have shown sensitivity to the syndrome that approximates that of the human population. We describe cases of VLS in three-month-old adult and one-month-old Sprague-Dawley rats in an osteogenesis study aimed at optimizing correction of bone hypoplasias and other craniofacial deformities in children, using a mandibular distraction device. In the study reported here, VLS was diagnosed in 40% of the rats that were necropsied after dying or being euthanized early, subsequent to mandibular osteotomy, a procedure that involves minimal bone trauma. The gross and histologic findings, as well as the clinical course of VLS in the rats of the osteogenesis study, were similar to those of documented human cases. Hence, the rat may be a useful animal model to h elp characterize the physiologic and molecular events that accompany this syndrome.

Animals↗
PubMed2003

[Using TiNi-SMA distractor for mandibular alveolar ridge augmentation by distraction osteogenesis: a preliminary study].

OBJECTIVE: To study the possibility of mandibular alveolar ridge augmentation by distraction osteogenesis using TiNi-SMA (shape memory alloy) distractor. METHODS: All of the mandibular premolars and the first molar were extracted from ten adult mongrel canines. One month later, box-shaped osteotomies of the alveolar bone were performed out and TiNi-SMA distractors were buried in experimental group. The bone height was measured before and 1, 5, 13 weeks after the operation. The radiographs were taken on the day of, and 1, 5, 13 weeks after operation. The animals were killed at one or three months after distraction and examined histologically. RESULTS: The bone segments were lifted up immediately after the insertion of distractors and the height achieved 7.5 - 11.5 mm one week after the operation. One month after distraction, the radiographs showed there was regeneration of bone in distraction gap. The new bone and the normal bone could not be differentiated clearly three months after distraction. No bone resorption was found during this period. In histological sections, there were collagen bundles in early distraction, then these bundles were calcified and became traeculaes. CONCLUSION: It suggests that the canine mandibular posterior alveolar ridge can be augmented by distraction osteogenesis using TiNi-SMA distractor, and the new bone is formed by intramembranous ossification.

Alloys↗
PubMed2003

Distraction osteogenesis and tissue engineering--new options for enhancing the implant site.

In severe atrophy of the mandible, implant placement in original bone may not be possible. In this field, augmentation procedures have already been described and controversially discussed. By the use of distraction osteogenesis, bone augmentation without donor morbidity is obtained, while the implant-bone interface remains in original bone. Despite soft tissue expansion during the distraction process, a lack of attached gingiva may cause difficulties at the implant site. In certain cases, an additional soft tissue augmentation procedure has to be performed for a good long-term functional and esthetic rehabilitation. The connective tissue graft and the free gingival graft are recommended to be standard procedures to create a stable periimplant mucosa, but the morbidity and the size limitation of the donor site have to be taken into consideration in selected patients. Transplantation of in vitro-cultured keratinocytes could be an alternative. Distraction osteogenesis and tissue engineering of keratinocytes, as well as bone-cultivating techniques, may increasingly be valuable adjuncts to current augmentation procedures.

Adult↗
PubMed1975

[Otosclerosis like bone in osteogenesis imperfecta tarda].

Bone like in otosclerosis from a 34-years-old man, from 33 years and 22 years old women, suffering from osteogenesis imperfecta tarda, with hardness of hearing in both ears were removed with chisel from the lower border of the oval window. After that a stapedectomy was accomplished. The stapedial crura have been genetically interrupted or broken, the footplate attached to the oval window. The bone from the border of the oval window was prepared for the histological examination. The specimens were coloured with Hematoxylin-Eosin and corresponding to Gomöri. In the bone similar cartilage osteoclasia and osteogenesis are rare. There are in the chondroosseous bone rooms filled with connective tissue. The diseased osseous labyrinth in osteo genesis imperfecta tarda must be regarded as a special morphogenetic formation of osteopsathyrosis.

Adult↗
PubMed2003

[Experimental study of TGF-beta 1 in the mandibular distraction osteogenesis process].

OBJECTIVE: To study the expression and function of TGF-beta 1 in the monkey's mandibular distraction osteogenesis process. METHODS: Sixteen rhesus monkeys were used for unilateral and bilateral mandibular distraction osteogenesis. Mandibular osteotomy was done at the mandible angle. After 5 days of latency period, the distraction was initiated at the rate of 0.5 mm x 2/day, lasting totally 15 days. In different periods after distraction completed, the bone in the distraction gap was routinely treated for immunohistochemistry and histology study. RESULTS: In the early period after distraction, the positive stain of TGF-beta 1 granules distributed extensively in the fibrous and vessel bases in the distraction gap, and in the cytoplasm of osteoblasts and chondroblasts. During the consolidation period, the positive stain of TGF-beta 1 granules alleviated gradually, and mainly distributed in the area where collagen fibers were ossifying and osteoids were forming, especially in the platelet and in the cytoplasm of vessel endothelial cells and osteoblasts. Twelve weeks after distraction, positive stain of TGF-beta 1 could seldom be seen except in the marrow's fibrous and vessel bases. CONCLUSIONS: TGF-beta 1 actively participates in the new bone forming process in the distraction gap. It may play an important role in stimulating and inducing proliferation and differentiation of primitive mesenchymal cells, and can enhance the proliferation of osteoblasts and vessel endothelial cells.

Animals↗