Midface Osteodistraction: Bone Formation
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Adi Rachmiel, DMD, Dov Laufer, DMD, Dina Lewinson, PhD

Introduction

Distraction osteogenesis is a technique of generating new bone by stretching a reparative callus. The method was developed and popularized by Ilizarov for endochondral bones that were subjected to progressive distraction following osteotomy (Ilizarov et al., 1980; 1988). Up to 30 cm of limb lengthening has been achieved when using this technique. Ilizarov also reported that bone distraction is accompanied by lengthening the associated soft tissue, including skin, muscles, and nerves (Ilizarov, 1984).

For membranous bones of the facial skeleton, distraction osteogenesis was described in several animal studies (Snyder et al., 1973; Michieli & Miotti, 1977; Karaharju-Suvanto et al., 1990; Karp et al., 1990; Rachmiel et al., 1993) and human mandibular (McCarthy et al., 1992; Rachmiel et al., 1995) and maxillary (Molina, 1994) lengthening.

It is known that changes in force or function of bone are followed by certain changes in internal architecture (Wolf, 1892; Mikuni-Takagaki et al., 1993). Few histological studies, however, have demonstrated formation and maturation of craniofacial bone in the expanded area (Karp et al., 1990; Rachmiel et al., 1993).

The purpose of this study was to analyze the histolomorphological changes that occurred during maxillary osteodistraction and to evaluate the quality of the newly formed bone 1 year after lengthening.