Expression of TGF-β1, Osteonectin, and BMP-4 in Mandibular Distraction Osteogenesis With Compression Stimulation: Reverse Transcriptase-Polymerase Chain Reaction Study and Biomechanical Test

Purpose: This study compared the levels of transforming growth factor-beta 1 (TGF-beta 1), osteonectin, and bone morphogenetic protein-4 (BMP-4) expression in regenerated bone in a rabbit mandible that had undergone conventional distraction osteogenesis (DO) with those in regenerated bone from a modified DO technique with compression stimulation. Materials and Methods: A total of 42 rabbits were used in this reverse transcriptase-polymerase chain reaction study. In the control group, distraction was performed at 1 mm/day for 8 days. In the experimental group, overdistraction was performed for 10 days, followed by a 3-day latency period and 2 days of compression to achieve the same amount of DO. Three rabbits per subgroup were killed at 0, 5, 13, 20, 27, 34, and 41 days after the initial osteotomy. The levels of TGF-beta 1, osteonectin, and BMP-4 in the bone regenerates were measured by reverse transcriptase-polymerase chain reaction. A biomechanical microhardness test was also performed in 8 rabbits as a separate experiment. Results: Reverse transcriptase-polymerase chain reaction revealed a greater level of TGF-beta 1 in the experimental group immediately after applying the compression force that continued for 2 weeks. The level then decreased to that of the control group at 3 weeks. The greater level of osteonectin in the experimental group after compression than that in the control group continued for 3 weeks. In the experimental group, the level of BMP-4 increased immediately after compression. However, the level in the control group decreased. The microhardness ratio of distracted bone to normal bone on the cortex was statistically different at 0.47 in the control group and 0.80 in the experimental group (P = .049) at 55 days after osteotomy. Conclusion: The effectiveness of the new DO technique with compression stimulation was confirmed by the gene expression study and the biomechanical test findings. (C) 2010 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 68:2076-2084, 2010