AimTo assess the possibility of vertical alveolar ridge augmentation by means of activation of the periosteum.Materials and MethodsSix adult male Beagle dogs were used for the study. All premolars and first molars were extracted, and one vertical saucer‐shaped bony defect was created on each side of the mandible. After 3 months of healing, full‐thickness muco‐periosteal flaps were elevated, and one distraction device was placed on each side of the mandible. The distraction plate was left submerged, and the activation mechanism connected to the distraction rod was exposed intra‐orally. The protocol of periosteal activation (PP: periosteal ‘pumping’) was initiated after a latency of 7 days. The alternation of activation and relaxation at the rate of 0.35 mm/12 h during 5 days was followed by the sole activation of 0.35 mm/12 h for 5 days (PP group). Devices were left inactivated on the contralateral control side of the mandible (C group). All animals were euthanized after 8 weeks of consolidation. Samples were analysed histologically and by means of micro‐CT.ResultsNew mature lamellar bone was formed over the pristine bone in all groups. More intensive signs of bone modelling and remodelling were observed in the PP group compared to the C group. Mean new bone, bone marrow, connective tissue and total volumetric densities were greater in the PP group (p < 0.001, p = 0.001, p = 0.003 and p < 0.001, respectively). No differences were observed in the relative area parameters. Total tissue volume and bone volume were higher in the PP group (p = 0.031 and p = 0.076, respectively), while the bone mineral densities were higher in the C group (p = 0.041 and p = 0.003, respectively). Trabecular number, trabecular thickness and trabecular separation values were similar between the two groups.ConclusionsRegeneration of vertical alveolar bone ridge defects may be enhanced by activation of the periosteum, without the application of bone grafting materials.

中文翻译：

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通过骨膜激活实现垂直牙槽嵴再生——原理验证研究


目的 评估通过激活骨膜增强垂直牙槽嵴的可能性。材料和方法该研究使用了 6 只成年雄性 Beagle 犬。拔除所有前磨牙和第一磨牙，并在下颌骨的每一侧产生一个垂直的碟形骨缺损。愈合 3 个月后，全层粘膜骨膜瓣抬高，并在下颌骨两侧放置一个牵引装置。将牵引板浸没在水中，连接到牵引杆的激活机制在口腔内暴露。骨膜激活方案 （PP： periosteal 'pumping'） 在潜伏期 7 天后启动。在 5 天内以 0.35 mm/12 h 的速率交替激活和松弛，然后以 0.35 mm/12 h 的速率交替激活 5 天（PP 组）。下颌骨对侧控制侧的装置失活 （C 组）。所有动物在巩固 8 周后均被安乐死。通过组织学和显微 CT 对样本进行分析。结果所有组均在原始骨上形成新的成熟板层骨。与 C 组相比，PP 组观察到更强烈的骨建模和重塑迹象。PP 组的平均新骨、骨髓、结缔组织和总体积密度较高 （分别为 p < 0.001、p = 0.001、p = 0.003 和 p < 0.001）。在相对面积参数中未观察到差异。PP 组的总组织体积和骨体积较高 （分别为 p = 0.031 和 p = 0.076），而 C 组的骨矿物质密度较高 （分别为 p = 0.041 和 p = 0.003）。 两组小梁数量、小梁厚度和小梁分离值相似。结论垂直牙槽骨嵴缺损的再生可能通过骨膜的激活而增强，而无需应用骨移植材料。