The effect of periosteal injury and masticatory micromovement on the healing of a mandibular distraction osteogenesis site

Objectives: Surgical periosteal injury and masticatory loading are likely factors affecting the healing of a mandibular DO site. This study is aimed to characterize the healing features of an early-phase mandibular DO site and assess the effects of these factors. Design: Eighteen 3-6-month-old miniature pigs received a right mandibular osteotomy and were distracted for 5 days (1 mm/day) and consolidated for 0,1 or 2 weeks (Groups A, B and C, respectively). Bone formation, chondrogenesis and vascular structure of the distraction site were measured using histological methods and their changes with consolidation time were characterized. The effect of periosteal injury was assessed by comparing the more severely injured lateral side with the less disturbed medial side. The effect of masticatory loading was evaluated by relating the healing features to the inter-fragmentary micromovement caused by soft-diet mastication. Results: With consolidation time, bone formation and chondrogenesis became stronger whilst vascular structure became more mature. Compared to the medial side, bone formation and chondrogenesis on the lateral side were significantly delayed in Groups A and B, but not in Group C, in which periosteal recovery had occurred. No difference was found for vascular measurements between the medial and lateral sides. In Group B, bone formation, but not chondrogenesis or vascular structures, tended to be negatively correlated with the magnitude of masticatory micromovement during the distraction phase. Conclusion: The results suggest that periosteal injury inhibits early mandibular DO site healing, whereas micromovement from soft-diet mastication mechanics has a negligible effect. (c) 2008 Elsevier Ltd. All rights reserved.