Effects of hyperbaric oxygen therapy on an accelerated rate of mandibular distraction osteogenesis

• Published in: Journal of plastic, reconstructive & aesthetic surgery reconstructive & aesthetic surgery, 2009-12, Vol.62 (12), p.1568-1572
• Main Authors: Salgado, Christopher J, Raju, Ashish, Licata, Lauren, Patel, Mitul, Rojavin, Yuri, Wasielewski, Samantha, Diarra, Cheikna, Gordon, Akil, Norcross, Alessandra, Kent, Kathryn A
• Format: Article
• Language: English
• Subjects: Animals; Biological and medical sciences; Bone Density; Cell physiology; Combined Modality Therapy; Consolidation; Distraction osteogenesis; Fundamental and applied biological sciences. Psychology; Hyperbaric oxygen; Hyperbaric Oxygenation - methods; Latency; Mandible; Mandible - physiopathology; Mandible - surgery; Medical sciences; Mineralization, calcification; Molecular and cellular biology; Osteogenesis, Distraction - methods; Plastic Surgery; Rabbit; Rabbits; Skeleton and joints; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Time Factors; Treatment Outcome; Vertebrates: osteoarticular system, musculoskeletal system; Wound Healing
• ISSN: 1748-6815; 1878-0539
• DOI: 10.1016/j.bjps.2008.06.071

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 1 mm and 2 mm/day with and without hyperbaric oxygen (HBO) therapy. Following a 5-day latency period, mandibular lengthening of 15 mm 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 2 mm/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 (1 mm/day distraction, no HBO therapy), 0.228 ± 0.09 in Group 2 (1 mm/day distraction, + HBO therapy), 0.180 ± 0.1 in Group 3 (2 mm/day distraction, no HBO therapy), and 0.269 ± 0.05 in Group 4 (2 mm/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 1 mm/day and 2 mm/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.