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Osteogenic capacity of vascularised periosteum: An experimental study on mandibular irradiated bone in rabbits

Jacques YachouhaCorresponding Author Informationemail address, Pierre Bretonb, Jean-Paul Rouxc, Patrick Goudota

Received 21 July 2008; accepted 19 January 2010. published online 02 March 2010.
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Summary 

Background

Free flaps are presently the best way to treat advanced mandibular ostonecrosis. Nevertheless, the functional and morphological results can be improved. To avoid a mandibular resection, a free periosteal flap was envisioned. In a preliminary study, the authors opted for a pedicled periosteal flap and evaluated the effect of the latter on regeneration of a rabbit irradiated mandibular bone.

Methods

Two bone fragments were taken from the basilar part of the mandible of 15 rabbits through skin incision. Those fragments were then exposed to a 30-Gy irradiation. One bone fragment was implanted in a pedicled periosteal flap elevated from the medial aspect of the femur while the other was subcutaneously fixed as a control. We retrieved the fragments at day 10, 20, 30 and 90 to make a histological analysis without prior decalcification using histomorphometry technique.

Results

In the periosted fragments, an increased osteoblastic and osteoclastic activity as well as neovascularisation evoked intense remodelling. In the subcutaneous fragments, bone resorption was much more important than osteogenesis and vessels were absent.

Conclusion

We have concluded than periosteum, which has already been proven to be efficient in normal bone regeneration, can be just as such efficient in irradiated bone regeneration.

a Oral and maxillo-facial surgery department, Hôpital Lapeyronie, 371 avenue du Doyen Gaston Giraud, 34295 Montpellier cedex 5 France

b Oral and maxillo-facial department, centre hospitalier Lyon Sud, 69495 Pierre-Bénite Cedex France

c Inserm Research Unit 831, faculté de Medecine Laennec rue G. Paradin, 69372 Lyon cedex 08 France

Corresponding Author InformationCorresponding author. Tel.: +33677791421; fax: +33467336841.

 This article was presented at: XXVIII Congress of French Association of Maxillo-Facial Surgeons Annual Congress of Swiss Society of Maxillo-Facial Surgery.

PII: S1748-6815(10)00050-1

doi:10.1016/j.bjps.2010.01.015