Publication date: Available online 31 December 2015
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Dominik Dziewiecki, Sander van de Loo, Felix Gremse, Anita Kloss-Brandstätter, Frank Kloss, Vincent Offermanns, Kensuke Yamauchi, Peter Kessler, Bernd Lethaus
Periosteal distraction or elevation has been known as an experimental method to induce new bone formation. Although it uses the principles of distraction osteogenesis no further osteotomy is necessary. The purpose of this study was to test degradable PDLLA (poly-DL-lactide), PGA (polyglygolic acid) and non degradable (titanium) devices in a calvarian model in Göttingen Minipigs and to evaluate the point of origin of the new bone formation. All degradable devices collapsed to a certain extent within the observation time but osteoneogenesis took place in all materials after a consolidation time of 2, 4 and 6 weeks after implantation above and under the devices. No statistical significant differences between the materials were found. However, most bone formation took place in the space under the periosteum and above the devices (p<0.001). Periosteal elevation can produce new bone formation with degradable devices, which derives from the periosteum and the underlying bone. In this interaction the periosteum seems to contain the larger share.
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