Image Analysis of Lateral Alveolar Ridge Augmentation using Periosteal Distraction Osteogenesis

Abstract

The aim of this study was to evaluate a novel technique for inducing osteogenesis through original periosteal distraction in a canine mandible model. A periosteal distraction device was rigidly fixed to the mandible in three adult canines (i.e., six sides total). Two sides of 1 dog served as the control. In the experimental group, periosteal distraction was started 4 weeks after placement of the periosteal distraction device. The periosteum was distracted 0.5 mm per day until a height of 3 mm was reached. Distraction continued for 8 weeks. The animals were killed 14 weeks postoperatively. Radiographs were obtained after the devices were fitted and again after distracting the periosteum. Computed tomography (CT) was performed at weeks 1 and 8. Transverse images using OsiriX software were constructed based on the periosteal device to observe the amount of augmentation. Images over time were superimposed on the reference image using Photoshop software. It revealed the changes with time, which were measured. All 6 periosteal distraction devices remained rigidly fixed to the lateral surface of the mandibles. At completion of distraction, all operative sites had healed without evidence of infection or wound dehiscence. The amount of bone augmentation was calculated by comparing CT imagees. The experimental group showed increased width in the area of bone growth and in the bone itself on all six sides. Average increases were 0.7 mm in bone width and 3.31 mm in the area. Bone area and bone width were decreased slightly in the control group. There were significant differences between controls and the experimental group regarding bone width and bone area. We achieved bone augmentation using a custom-made periosteal distraction device. The amount of bone augmentation was calculated by comparing CT images.