Micro-computed tomography and histologic evaluation of the interface of hydrogel expander and underlying bone: influence of pressure distributors on bone resorption.
OBJECTIVE
Tissue expanders lead to changes in the underlying bone and can cause bone resorption. We investigated whether the insertion of mechanical devices that distribute the load on the bone can influence these effects.


METHODS
A total of 28 Lewis rats were assigned to 1 of 4 groups. Hydrogel expanders were placed subcutaneously either directly on the calvaria, on titanium mesh, or on a titanium plate. The fourth group of rats served as the controls. The bone quality and thickness were assessed beneath, and at the periphery of, the expanders using micro-computed tomography and histologic examination.


RESULTS
Micro-computed tomography images were obtained before and 21 days after insertion. The images revealed a significant decrease in hydroxyapatite density beneath the expanders in the group with only expanders. This decrease was reduced with the use of titanium mesh and completely prevented with the use of titanium plates. Histologic examination revealed a significant decrease in bone density and marked lacunae beneath the hydrogel expanders in the group with only expanders. In contrast, the titanium mesh decreased the size of the lacunae, and the titanium plates completely prevented both the formation of lacunae and the decrease in bone thickness.


CONCLUSIONS
The bone resorption caused by hydrogel expanders can be diminished using titanium mesh and completely prevented by the insertion of a titanium plate.
von See
Constantin
C
Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany. constuehmer@web.de
Rücker
Martin
M
Schumann
Paul
P
Goetz
Franziska
F
Wefstaedt
Patrick
P
Nolte
Ingo
I
von der Hoeh
Nina
N
Meyer-Lindenberg
Andrea
A
Tavassol
Frank
F
Gellrich
Nils-Claudius
NC
D000704:Analysis of Variance; D000818:Animals; D015519:Bone Density / Q000187:drug effects; D001860:Bone Plates; D001862:Bone Resorption / Q000209:etiology* / Q000517:prevention & control*; D001842:Bone and Bones / Q000000981:diagnostic imaging / Q000187:drug effects*; D017886:Durapatite; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate / Q000009:adverse effects*; D008297:Male; D011312:Pressure; D051381:Rats; D011917:Rats, Inbred Lew; D012886:Skull / Q000000981:diagnostic imaging / Q000601:surgery; D013526:Surgical Mesh; D015625:Tissue Expansion Devices / Q000009:adverse effects*; D014025:Titanium; D055114:X-Ray Microtomography
D020136:Hydrogel, Polyethylene Glycol Dimethacrylate; D017886:Durapatite; D014025:Titanium