Effects of hyperbaric oxygen therapy on an accelerated rate of mandibular distraction osteogenesis☆
Received 31 January 2008; accepted 11 June 2008. published online 06 February 2009.
Summary
Background
Distraction osteogenesis has become a standard therapy for lengthening of the human craniofacial skeleton. Because the technique is used predominately in a paediatric population, limiting the treatment protocol is beneficial.
Methods
Twenty-four animals were divided into four groups with distraction rates of 1mm and 2mm/day with and without hyperbaric oxygen (HBO) therapy. Following a 5-day latency period, mandibular lengthening of 15mm was performed with a uniaxial distractor along the body of the mandible. Consolidation period was 4 weeks in all groups. HBO therapy was administered to one of the 1 and 2mm/day groups 1 day preoperatively, throughout the latency and distraction phases and 2 weeks into the consolidation period. Animals were euthanised after consolidation and the mandibles harvested for bone mineral densitometry evaluation.
Results
The mean bone mineral density (BMD) (g/cm2) was 0.208±0.04 in Group 1 (1mm/day distraction, no HBO therapy), 0.228±0.09 in Group 2 (1mm/day distraction, + HBO therapy), 0.180±0.1 in Group 3 (2mm/day distraction, no HBO therapy), and 0.269±0.05 in Group 4 (2mm/day distraction, + HBO therapy). Using the Student's t-test for equality of means and the one-way analysis of variance (ANOVA), we found that the mean BMD was significantly higher in the groups that were administered HBO (Groups 2 and 4) than not (P=< 0.05). For the groups that had distraction of 1mm/day and 2mm/day, those that underwent HBO therapy had significantly higher BMD than those without HBO therapy (P=< 0.05).
Conclusion
We have found that HBO therapy may serve to augment the healing process in distraction osteogenesis, allowing for more rapid distraction in order to decrease the overall treatment time.
aDepartment of Plastic Surgery, Case Western University/UH Cleveland, Cleveland, OH, USA
bDepartment of Surgery, Cooper University Hospital/Robert Wood Johnson Medical School at Camden, Camden, NJ 08103, USA
Corresponding author.
☆ This study was funded in part by the Department of Clinical Investigations, William Beaumont Army Medical Center, El Paso, TX and the Division of Plastic Surgery, Department of Surgery, Cooper University Hospital, Camden, N.J.
This study was supported by KLS Martin Inc., Jacksonville, FL; Osteomed Inc., Addison, TX; and the USAFSAM Hyperbaric Medicine Division, USAF School of Aerospace Medicine, Brooks City-Base, TX, USA.
ABSTRACT