Distraction osteogenesis in irradiated rabbit mandibles with adjunctive hyperbaric oxygen therapy.
OBJECTIVE
The purpose of this study was to evaluate the effect of hyperbaric oxygen therapy on bone regeneration during distraction of irradiated rabbit mandibles.


METHODS
Twenty New Zealand white rabbits were randomly sub-divided into 4 groups. Group 1 served as control, group 2 received preoperative radiation therapy, group 3 received pre- and postoperative hyperbaric oxygen (HBO) therapy, and group 4 received preoperative radiation therapy and pre- and postoperative HBO therapy. All rabbits underwent a corticotomy of the left body of the mandible after placement of a distraction device. Distraction, at a rate of 1 mm/day and a rhythm of 1 turn/day, began after a 3-day latency period for 14 days. Thirty days after completion of the distraction protocol, the animals were euthanized, and histomorphometric and radiographic data of the distraction segments were obtained.


RESULTS
Histomorphometric analysis of new bone fill was greatest in the non-irradiated groups compared to groups receiving radiation therapy, regardless of HBO therapy (P = .03). Pre-corticotomy bone density measurements showed a significant increase in bone density over time (P = .0007). This resulted in a significant relationship between HBO therapy, radiation therapy, and time (P = .0050).


CONCLUSIONS
The results of the study support the use of HBO therapy during distraction osteogenesis. Any additional therapeutic benefit of HBO therapy in irradiated bone would require additional investigation.
Oral and Maxillofacial Surgery Service, Eisenhower Army Medical Center, Fort Gordon, GA 30905-5650, USA.
Charles L
CL
Clark
James
J
Strider
Chris
C
Hall
Henry W
HW
Ferguson
Karyn L
KL
Armstrong
Royce R
RR
Runner
Dale A
DA
Baur
D000704:Analysis of Variance; D000818:Animals; D015519:Bone Density; D001861:Bone Regeneration / Q000502:physiology*; D016371:Cranial Irradiation / Q000009:adverse effects*; D006931:Hyperbaric Oxygenation; D008334:Mandible / Q000528:radiation effects / Q000601:surgery*; D019647:Oral Surgical Procedures; D019857:Osteogenesis, Distraction; D011817:Rabbits; D011832:Radiation Injuries / Q000209:etiology / Q000628:therapy; D011897:Random Allocation