Influence of Periosteal Coverage on Distraction Osteogenesis With Dental Implant Distractors

Purpose: The continuity and integrity of the enveloping nutritive periosteum can be compromised during installation of a dental implant distractor (DID) device. This novel animal experiment investigated the influence of the periosteum on the bony regenerate in 3 scenarios of periosteal coverage: whole periosteum (WP), half periosteum (HP), and no periosteum (NP). Materials and Methods: Twelve goat tibias were vertically osteotomized into 2 segments each and divided into 3 groups (WP, HP, and NP). A DID device was surgically installed onto each segment, followed by 10 days of distraction at a rate of 0.35 mm twice daily. Fluorescence labeling and trabecula count per high-power field (TBC/HPF) measurements were performed and statistically compared across groups. Implant stability quotients (ISQs) of all fixtures were performed. Results: New bone formation occurred sooner in the WP and HP groups than in the NP group under fluoroscopy. The TBC/HPF values showed an obvious but not statistically significant decrease between the WP and HP groups (P =.500), WP and NP groups (P =.157), and HP and NP (P =.077). And the WP group showed no significantly higher ISQ values compared with the HP (P =.712) and NP (P =.958) groups, also between the HP and NP (P =.751) groups. Conclusion: Vertical distraction osteogenesis can be performed successfully with the DID to obtain bone of adequate stock and density. However, the enveloping periosteum should be preserved as much as possible during installation of the DID device. (C) 2014 American Association of Oral and Maxillofacial Surgeons