Vertical Alveolar Ridge Regeneration by Means of Periosteal Activation—A Proof-of-Principle Study

IF 5.8 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Journal of Clinical Periodontology Pub Date : 2024-08-15 DOI:10.1111/jcpe.14057

Nikola Saulacic, Niklaus P. Lang, Slavko Corluka, Maria Permuy Mendaña, Fernando M. Muñoz Guzón

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Abstract

Aim

To assess the possibility of vertical alveolar ridge augmentation by means of activation of the periosteum.

Materials and Methods

Six adult male Beagle dogs were used for the study. All premolars and first molars were extracted, and one vertical saucer-shaped bony defect was created on each side of the mandible. After 3 months of healing, full-thickness muco-periosteal flaps were elevated, and one distraction device was placed on each side of the mandible. The distraction plate was left submerged, and the activation mechanism connected to the distraction rod was exposed intra-orally. The protocol of periosteal activation (PP: periosteal ‘pumping’) was initiated after a latency of 7 days. The alternation of activation and relaxation at the rate of 0.35 mm/12 h during 5 days was followed by the sole activation of 0.35 mm/12 h for 5 days (PP group). Devices were left inactivated on the contralateral control side of the mandible (C group). All animals were euthanized after 8 weeks of consolidation. Samples were analysed histologically and by means of micro-CT.

Results

New mature lamellar bone was formed over the pristine bone in all groups. More intensive signs of bone modelling and remodelling were observed in the PP group compared to the C group. Mean new bone, bone marrow, connective tissue and total volumetric densities were greater in the PP group (p < 0.001, p = 0.001, p = 0.003 and p < 0.001, respectively). No differences were observed in the relative area parameters. Total tissue volume and bone volume were higher in the PP group (p = 0.031 and p = 0.076, respectively), while the bone mineral densities were higher in the C group (p = 0.041 and p = 0.003, respectively). Trabecular number, trabecular thickness and trabecular separation values were similar between the two groups.

Conclusions

Regeneration of vertical alveolar bone ridge defects may be enhanced by activation of the periosteum, without the application of bone grafting materials.

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通过骨膜激活实现垂直牙槽嵴再生--原理验证研究

目的：评估通过激活骨膜进行垂直牙槽嵴隆起的可能性：研究使用了六只成年雄性比格犬。所有前臼齿和第一臼齿均被拔除，下颌骨两侧各有一个垂直的碟形骨缺损。3 个月愈合后，抬高全厚粘骨膜瓣，并在下颌骨两侧各放置一个牵引装置。牵引板浸没在水中，与牵引杆相连的激活机制暴露在口腔内。骨膜激活（PP：骨膜 "抽动"）方案在潜伏 7 天后启动。在 5 天内以 0.35 毫米/12 小时的速度交替激活和放松，然后在 5 天内以 0.35 毫米/12 小时的速度单独激活（PP 组）。下颌骨对侧对照组（C 组）的装置处于失活状态。所有动物在巩固治疗 8 周后安乐死。对样本进行组织学和显微 CT 分析：结果：所有组的原始骨上都形成了新的成熟片状骨。与 C 组相比，PP 组观察到更密集的骨建模和重塑迹象。PP 组的平均新骨密度、骨髓密度、结缔组织密度和总体积密度更高（p 结论：PP 组的新骨密度、骨髓密度、结缔组织密度和总体积密度更高：在不使用骨移植材料的情况下，通过激活骨膜可促进垂直牙槽骨嵴缺损的再生。

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来源期刊

Journal of Clinical Periodontology 医学-牙科与口腔外科

CiteScore

13.30

自引率

10.40%

发文量

175

审稿时长

3-8 weeks

期刊介绍： Journal of Clinical Periodontology was founded by the British, Dutch, French, German, Scandinavian, and Swiss Societies of Periodontology. The aim of the Journal of Clinical Periodontology is to provide the platform for exchange of scientific and clinical progress in the field of Periodontology and allied disciplines, and to do so at the highest possible level. The Journal also aims to facilitate the application of new scientific knowledge to the daily practice of the concerned disciplines and addresses both practicing clinicians and academics. The Journal is the official publication of the European Federation of Periodontology but wishes to retain its international scope. The Journal publishes original contributions of high scientific merit in the fields of periodontology and implant dentistry. Its scope encompasses the physiology and pathology of the periodontium, the tissue integration of dental implants, the biology and the modulation of periodontal and alveolar bone healing and regeneration, diagnosis, epidemiology, prevention and therapy of periodontal disease, the clinical aspects of tooth replacement with dental implants, and the comprehensive rehabilitation of the periodontal patient. Review articles by experts on new developments in basic and applied periodontal science and associated dental disciplines, advances in periodontal or implant techniques and procedures, and case reports which illustrate important new information are also welcome.