Tissue differentiation and bone regeneration in an osteotomized mandible: a computational analysis of the latency period
Citation:
Boccaccio A., Prendergast P.J., Pappalettere C. and Kelly D.J. `Tissue differentiation and bone regeneration in an osteotomized mandible: a computational analysis of the latency period? in Medical and Biological Engineering and Computing, 46, (3), 2008, pp 283 - 298Download Item:
Abstract:
Mandibular symphyseal distraction osteogenesis is a common clinical procedure to modify the
geometrical shape of the mandible for correcting problems of dental overcrowding and arch
shrinkage. In spite of consolidated clinical use, questions remain concerning the optimal latency
period and the influence of mastication loading on osteogenesis within the callus prior to the first
distraction of the mandible. This work utilized a mechano-regulation model to assess bone
regeneration within the callus of an osteotomized mandible. A 3D model of the mandible was
reconstructed from CT scan data and meshed using poroelastic finite elements. The stimulus
regulating tissue differentiation within the callus was hypothesized to be a function of the strain and
fluid flow computed by the finite element model. This model was then used to analyse tissue
differentiation during a fifteen day latency period, defined as the time between the day of the
osteotomy and the day when the first distraction is given to the device. The following predictions
are made: (i) the mastication forces generated during the latency period support osteogenesis in
certain regions of the callus, and that during the latency period the percentage of progenitor cells
differentiating into osteoblasts increases; (ii) reducing the mastication load by 70% during the
latency period increases the number of progenitor cells differentiating into osteoblasts; (iii) the
stiffness of new tissue increases at a slower rate on the side of bone callus next to the occlusion of
the mandibular ramus which could cause asymmetries in the bone tissue formation with respect to
the middle sagittal plane. Although the model predicts that the mastication loading generates such
asymmetries, their effects on the spatial distribution of callus mechanical properties are
insignificant for typical latency periods used clinically. It is also predicted that a latency period of
longer than a week will increase the risk of premature bone union across the callus.
Author's Homepage:
http://people.tcd.ie/pprenderDescription:
PUBLISHED
Author: KELLY, DANIEL; Prendergast, Patrick John
Publisher:
SpringerSeries/Report no:
Medical and Biological Engineering and Computing46
3
Availability:
Full text availableKeywords:
Mechanobiology, Mandibular distraction osteogenesis, Orthodontic devices, Tissue differentiation, Finite element modellingISSN:
49633Metadata
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