| 2974 Assessment of the Temporomandibular Joint after Biphasic Callus Distraction of the Mandible in a Canine Model | ||
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E.C. ROSE1, K. IMMENKAMP1, C. SURWALD2, C. KUNZ3, C.-P. ADLER1, B.A. RAHN4, and I.E. JONAS1, 1 University of Freiburg i. Br, Germany, 2 Queen Victory Hospital, East Grinstead, West Sussex, United Kingdom, 3 Kantonsspital, University of Basel, Switzerland, 4 AO- Research Institute, Davos Platz, Switzerland Objective: Biphasic distraction osteogenesis is a new technique for mandibular lengthening to prevent anterior open bite. Applying distraction osteogenesis at the mandible results also in incongruence of the condyles in the temporomandibular fossa. The purpose of this study was to assess in a canine model the adaptive capacity of the temporomandibular joint to sagittal callus distraction followed by an angulation procedure of the mandible. Methods: Bilateral, mandibular distraction was performed in 30 adult beagle dogs using an extraoral, multiplanar distraction device. The protocol consisted of 5 day latency and a distraction rate of 1 mm/d for 10 days, at day 11 a cranial angulation of 20°/30° was performed, the consolidation period was 6 and 13 weeks, respectively. After the animals were sacrificed, the temporomandibular joints were harvested, processed for histologic examination and histomorphometric analysis. Fourteen beagle dogs matched in age and gender from another independent study with no mandibular callus distraction served as reference group. Results: Significant adaptive remodeling was observed in the temporomanidbular joints of all animals of the study group. After 6 weeks the alterations were mainly found at the condyles, but after 13 weeks they occurred at the condyles and in the glenoid fossae. The width of the cartilage was significantly changed in the central and lateral areas. In individual cases regressive adaptive changes, such as focal, subchondral bone necrosis, deep vascularisation, osteoclastic resorption and formation of chondral clefts were observed. Conclusion: The temporomandibular joint demonstrated its high adaptive capacity to compensate incongruence between the condyle and the glenoid fossa caused by distraction osteogenesis of the mandible. However, one should be aware of degenerative changes in the temporomandibular joint after biphasic distraction of the mandible. | ||
| Seq #299 - Osteogenic Distraction / Orthognathic Surgery 1:30 PM-3:30 PM, Saturday, 28 June 2003 Svenska Massan F2 | ||
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