Effects of Cortical Bone Perforation on Periosteal Distraction: An Experimental Study in the Rabbit Mandible

Purpose: To investigate tissue reactions using periosteal distraction with decorticating holes in a rabbit model. Materials and Methods: Twenty-five Japanese white rabbits weighing 3.2 to 3.7 kg were used. The periosteum was carefully detached, and the buccal cortical bone was porously perforated by drilling in the decortication group. Titanium mesh was placed between the periosteum and the cortical bone, with or without holes. A distraction screw was placed rigidly under the center of the mesh. After a 7-day latency period, the periosteum was distracted 0.5 mm per day for 8 consecutive days. Rabbits were sacrificed after consolidation periods of 4 and 8 weeks. Cross-sectional radiographs were evaluated with densitometry. Specimens were fixed, decalcified, and stained with hematoxylin and eosin. Results: At 8 weeks after periosteal distraction, the area of new bone formation averaged 25.7 +/- 5.1 mm(2) and 12.9 +/- 3.2 mm(2) (mean +/- SD) with and without decortication, respectively. In this study, periosteal distraction showed better bone regeneration on the lateral aspect of mandibles with rather than without decorticating holes. Conclusion: Periosteal distraction with decorticating holes can be effective in augmenting atrophic bone. (C) 2009 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 67:1478-1485, 2009