Successful Distraction Osteogenesis across a Growing Cranial Suture without an Osteotomy

The purpose of the present study was to observe the response and changes of cranial suture to the distraction forces in growing goats and to examine the expression patterns of TGF-β and BMP during suture distraction.Twenty growing goats were divided into three groups: control (n=4), experimental (n=12), and sham (n=4). A pure titanium distractor was placed in the coronal suture in both the sham and experimental groups. After healing, the distractor was activated for distraction of the coronal suture at a rate of 0.5 mm/day for 8 days in the experimental group. Three animals were killed respectively, at 0，2，4 and 8 weeks after completion of suture distraction. No force was applied in the sham group. X- Ray examination was taken and the coronal suture samples were harvested and processed for histological analysis and scanning electron microscopic analysis and immunohistochemistry of TGF-β and BMP. The coronal sutures of experimental group were separated successfully. Signs of intramembranous bone formation and remodeling were found in the distracted suture，and the sutural structure almost return to its normal state at 8 weeks after end of distraction. At 0 and 2 weeks after completion of suture distraction, the collagen fiber bundles were strengthened and aligned in the direction of the distracted forces. Strong expression of BMP and TGF-β were detected in the fibroblast-like cells and the active osteoblasts. At 4 weeks after suture distraction, signs of intramembranous ossification were found in the edge areas of the distracted suture, and the positive staining of BMP and TGF-β was still noted in the osteoblasts around the newly formed bone trabeculae. This study suggests that cranial suture expansion can be achieved in growing animal by distraction osteogenesis. Mechanical strain resulted from distractor can induce the adaptive remodeling in the cranial suture of growing goats. It also suggests BMP and TGF-β may play very important roles in the process of bone formation and remodeling during suture distraction osteogenesis.

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The Bone Remodeling and Cellular Responses to Cranial Suture Distraction Osteogenesis in Growing Goats

Advanced Biomaterials VII - Key Engineering Materials ◽

10.4028/0-87849-436-7.5 ◽

2007 ◽

pp. 5-8

Author(s):

Qi Feng Zhang ◽

Shu Juan Zou ◽

Hai Xiao Zhou ◽

Yang Xi Chen ◽

Meng Chun Qi ◽

...

Keyword(s):

Bone Remodeling ◽

Distraction Osteogenesis ◽

Cellular Responses ◽

Cranial Suture ◽

Growing Goats

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New Developments in Craniofacial Surgery Research

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569_1999_036_0377_ndicsr_2.3.co_2 ◽

1999 ◽

Vol 36 (5) ◽

pp. 377-387 ◽

Cited By ~ 3

Author(s):

Babak J. Mehrara ◽

Michael T. Longaker

Keyword(s):

Developmental Biology ◽

Distraction Osteogenesis ◽

Molecular Mechanisms ◽

Craniofacial Surgery ◽

Cranial Suture ◽

New Developments ◽

Mandibular Distraction Osteogenesis ◽

Surgery Research ◽

Craniofacial Biology ◽

Suture Fusion

The recent explosion in our understanding of developmental biology and genetics has enhanced our understanding of craniofacial biology. While it is not possible to summarize all new developments in craniofacial research, this article will review three areas: fetal models and surgery for craniofacial disorders, the biology of distraction osteogenesis, and the molecular mechanisms of cranial suture fusion. Numerous models of craniofacial disorders have been described, including small, short gestation and large, long gestation. The benefits and shortcomings of each are discussed. In addition, we discuss recent studies investigating the molecular mechanisms of mandibular distraction osteogenesis. Finally, we present a review of recent advances in the understanding of mechanisms of craniosynostosis, with particular emphasis on the biology of programmed cranial suture fusion in rodents.

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Distraction Osteogenesis in the Treatment of Craniofacial Anomalies: Applications and Outcomes

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2020_persp-20-00055 ◽

2020 ◽

Vol 5 (6) ◽

pp. 1469-1481 ◽

Cited By ~ 1

Author(s):

Joseph A. Napoli ◽

Carrie E. Zimmerman ◽

Linda D. Vallino

Keyword(s):

Distraction Osteogenesis ◽

Bone Growth ◽

Upper Airway ◽

Craniofacial Anomalies ◽

Craniofacial Skeleton ◽

Facial Skeleton ◽

Psychosocial Impairment ◽

And Function ◽

Correct Structure

Purpose Craniofacial anomalies (CFA) often result in growth abnormalities of the facial skeleton adversely affecting function and appearance. The functional problems caused by the structural anomalies include upper airway obstruction, speech abnormalities, feeding difficulty, hearing deficits, dental/occlusal defects, and cognitive and psychosocial impairment. Managing disorders of the craniofacial skeleton has been improved by the technique known as distraction osteogenesis (DO). In DO, new bone growth is stimulated allowing bones to be lengthened without need for bone graft. The purpose of this clinical focus article is to describe the technique and clinical applications and outcomes of DO in CFA. Conclusion Distraction can be applied to various regions of the craniofacial skeleton to correct structure and function. The benefits of this procedure include improved airway, feeding, occlusion, speech, and appearance, resulting in a better quality of life for patients with CFA.

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