Experimental testing and histology result of the continuous distraction device application at the various rates

Abstract

Relevance. In modern maxillofacial surgery, the technique and mechanism of compression-distraction osteogenesis are still relevant as an alternative method of obtaining bone tissue in complex clinical cases. All types of compression-distraction devices used in practice have only a mechanical drive, i.e., fragments of bone tissue are separated fractionally in such devices, creating uneven tension in the newly formed regenerate, which leads to its incomplete ossification. We have developed, tested on a stand and tested in an animal experiment a distraction appliance operating on the principle of continuous separation of bone fragments, having a piston-type motor, activation of which occurs during an electrochemical reaction triggered and controlled by software with a feedback kit.Material and methods. The stages of our research were as follows: development of devices and electronics, bench tests, creation of clinical models of an automated continuous distraction device; clinical trials of devices, their placement in the experiment animals (dogs), testing of electronic continuous distraction devices at various rates (1 mm, 2 mm, 3 mm per day); morphological and clinical and radiographic evaluation of the bone regenerates, and development of clinical recommendations for the device application and distraction rates.Results. The received data based on the available clinical and morphological-radiographic picture between the bone fragments distracted by the device prove the possibility of regenerate formation during continuous distraction at various rates, when constant atraumatic stretching of the regenerate is maintained, without its transition to a fractional deformation similar to a pre-plastic one. At the same time, the analysis of morphological studies showed the best histomorphological regenerate maturity obtained by continuous distraction at a rate of 2 mm. per day.Conclusion. We can recommend the introduction of the automated continuous distraction device created by our experienced group into practical medicine at a distraction rate of 2 mm. per day.