Histological and physical analysis of bone neoformation by osteogenesis distraction: A preliminary report

Abstract

Introduction:Osteogenesis distraction (OD) is a mainstream technique in maxillofacial surgical reconstruction with varied applications. OD technique employs a distractor with the aim to get new bone in the site of interest. Osseous maturation time is necessary before the device can be removed and few patients’ complaint of related discomfort, especially when these devices are external, and induces superficial infections, paresthesia, hypertrophic scars and social relationship difficulties. The use of Low Level Laser Therapy (LLLT) has been proved beneficial to soft tissue and osseous repairs.Materials and Method:12 rabbits were randomly divided in to two groups. In all animals, distractor was placed and one group was exposed to LLLT while the other group served as control. After consolidation, animals were sacrificed, the new bone formed were subjected to investigations including histomorphometric, physical analysis and tomographical analysis. Statistical analyses were performed using SPSS software.Result:Newly formed bone was significantly different between the groups. The physical properties of the neobone were comparatively better when the animals were exposed to LLLT with varying statistical significance.Conclusion:The results obtained with smaller sample size in this study need to be interpreted with care. The results of this preliminary pilot study encourage the use of LLLT during healing period. However the histological, tomographical and physical findings need to be ascertained using a larger sample size to study the bio-stimulatory effects with laser therapy from basics to clinical relevance on wound and bone healing.

The Effect of Photobiomodulation on Distraction Osteogenesis

“…Three studies did not mention the type of the laser and one study only mentioned the commercial brand-name of the laser device. 38…”

“…Moreover, the current study reviewed seven articles on the effects of LLLT on the consolidation phase of DO. [36][37][38]40,46,49,51 Six studies evaluated the effect of LLLT on the activation phase of DO 39,41,44,45,47,52 and three studies evaluated the effect of LLLT on the latency and activation phases of DO. 42,43,50 However, Angeletti et al 50 did not accurately mention these two phases but the timing of laser irradiation was within these two phases.…”

“…The reviewed studies had some differences regarding the location of corticotomy incisions in DO. Studies on the mandible of rabbits also had different locations of incision, including distal to the mental foramen and distal to the first molar, 39 between the first premolar and mental foramen, 48 at 1 mm distance from the mesial root of the first molar, 41,44 in the medial and lateral cortices right in front of the first premolar, 43 anterior to the molar teeth and posterior to the mental foramen, 45 1 cm mesial to the ramus, 46 between the premolar site and mental foramen, 38,47 and body of mandible right behind the mental foramen. 52 Two studies on the mandible of rabbits did not mention the exact location of the incision and they only discussed that an incision was made in such a way that the inferior alveolar nerve was not traumatized.…”

“…47 Another study reported direct irradiation of DO site in the consolidation phase every 48 hours. 38 In another study, 3 points in the palate measuring 0.06 cm 2 were irradiated (I) the first point was at the incisive papilla, (II) the second point was at the line connecting the two lateral incisors 2 mm right to the mid-palatal raphe, and (III) the third point was at the line connecting the two lateral incisors 2 mm left to the mid-palatal raphe. One dose of the laser was irradiated in each session and each patient underwent a total of 8 sessions of laser therapy.…”