title: Influence of periosteal coverage on distraction osteogenesis with dental implant distractors.
abstract: OBJECTIVE
  The continuity and integrity of the enveloping nutritive periosteum can be compromised during installation of a dental implant distractor (DID) device. This novel animal experiment investigated the influence of the periosteum on the bony regenerate in 3 scenarios of periosteal coverage: whole periosteum (WP), half periosteum (HP), and no periosteum (NP).
  
  
  METHODS
  Twelve goat tibias were vertically osteotomized into 2 segments each and divided into 3 groups (WP, HP, and NP). A DID device was surgically installed onto each segment, followed by 10 days of distraction at a rate of 0.35 mm twice daily. Fluorescence labeling and trabecula count per high-power field (TBC/HPF) measurements were performed and statistically compared across groups. Implant stability quotients (ISQs) of all fixtures were performed.
  
  
  RESULTS
  New bone formation occurred sooner in the WP and HP groups than in the NP group under fluoroscopy. The TBC/HPF values showed an obvious but not statistically significant decrease between the WP and HP groups (P = .500), WP and NP groups (P = .157), and HP and NP (P = .077). And the WP group showed no significantly higher ISQ values compared with the HP (P = .712) and NP (P = .958) groups, also between the HP and NP (P = .751) groups.
  
  
  CONCLUSIONS
  Vertical distraction osteogenesis can be performed successfully with the DID to obtain bone of adequate stock and density. However, the enveloping periosteum should be preserved as much as possible during installation of the DID device.
authors.affiliation: Resident, Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China.
authors.forename: Xuelai
authors.initials: X
authors.lastname: Yin
authors.affiliation: Department Head, Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China.
authors.forename: Chenping
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Attending Physician, Department of Oral and Maxillofacial Surgery, Khoo Teck Puat Hospital, Yishun, Singapore.
authors.forename: Eugene Poh
authors.initials: EP
authors.lastname: Hze-Khoong
authors.affiliation: Resident, Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Professor, Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China. Electronic address: maxiliaxu@163.com.
authors.forename: Liqun
authors.initials: L
authors.lastname: Xu
mesh_terms: D000818:Animals; D000880:Anthraquinones; D015519:Bone Density / Q000502:physiology; D001861:Bone Regeneration / Q000502:physiology; D004396:Coloring Agents; D015921:Dental Implants; D005452:Fluoresceins; D005456:Fluorescent Dyes; D005471:Fluoroscopy / Q000379:methods; D006041:Goats; D016268:Internal Fixators; D008297:Male; D018613:Microscopy, Confocal / Q000379:methods; D023421:Models, Animal; D016348:Osseointegration / Q000502:physiology; D010012:Osteogenesis / Q000502:physiology; D019857:Osteogenesis, Distraction / Q000295:instrumentation*; D010027:Osteotomy / Q000379:methods; D010521:Periosteum / Q000502:physiology*; D013977:Tibia / Q000601:surgery; D013997:Time Factors; D014048:Tolonium Chloride
chemical_list: D000880:Anthraquinones; D004396:Coloring Agents; D015921:Dental Implants; D005452:Fluoresceins; D005456:Fluorescent Dyes; D014048:Tolonium Chloride; C004468:Alizarin Red S; C007740:fluorexon