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


CONCLUSIONS
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.
Yachouh
Jacques
J
Oral and maxillo-facial surgery department, Hôpital Lapeyronie, 371 avenue du Doyen Gaston Giraud, 34295 Montpellier cedex 5, France. jacquesyachouh@free.fr
Breton
Pierre
P
Roux
Jean-Paul
JP
Goudot
Patrick
P
D000818:Animals; D001861:Bone Regeneration / Q000502:physiology* / Q000528:radiation effects*; D058752:Free Tissue Flaps; D008334:Mandible / Q000528:radiation effects*; D010521:Periosteum / Q000098:blood supply; D011817:Rabbits; D013524:Surgical Flaps / Q000098:blood supply* / Q000502:physiology*