Periodontal impact of surgically induced dental lesions in mandibular osteodistraction: An animal study

Abstract

SUMMARY. Aim: The objective of the study was to evaluate the impact of dental lesions on the periodontium, in a canine model of mandibular osteodistraction. Material and methods: In six adult male Beagle dogs, an osteotomy was made between the right second lateral incisor and canine, and a distraction device placed. The roots adjacent to the osteotomy were deliberately damaged by the reciprocating saw and chisel, with preservation of the attached gingiva. The osteodistraction protocol used was: latency of 7 days, rate of distraction 1 mm per day, and rhythm once a day for 5 days. Vital staining was carried out with tetracycline, Xylenol Orange and Calcein Green. The dogs were sacrificed after 12 weeks of consolidation and the specimens were evaluated with light microscopy (native, polarized light, fluorescence, and after toluidin blue staining). Results: The periodontal ligament (PDL) regeneration was observed in the 2500 slices examined. Cementum and dentine lesions were repaired by cellular cementum. Loose dentine and cementumedentine fragments were embedded in regenerated PDL and their surface repaired by cementum. By means of light microscopic examination and within the limited observation time, no degenerative pulpal changes were found, when the pulp canal was not entered. Extensive pulp exposure and destruction resulted in ingrowth of the PDL and bone-like tissue. In that case, cellular cementum also lined the dentine surface of the pulp canal. Conclusion: Although there was an extensive reparative response to the para-pulpal lesions, none of the changes observed showed evidence of a loss of functional integrity of the periodontium at the distraction site. The fate of the tooth with exposed pulp canal remains uncertain. Ó 2008 European Association for Cranio-Maxillofacial Surgery