Korean J Orthod.  2019 Jul;49(4):235-245. 10.4041/kjod.2019.49.4.235.

Alveolar restoration following rapid maxillary expansion with and without corticotomy: A microcomputed tomography study in sheep

• Le MH
• Noor Hayaty AK
• Zaini ZM
• Dom SM
• Ibrahim N
• Radzi ZB

• KMID: 2453060
• DOI: http://doi.org/10.4041/kjod.2019.49.4.235

Abstract

OBJECTIVE
This study examined bone microstructure restoration after rapid maxillary expansion (RME) with and without corticotomy over multiple retention periods.
METHODS
Eighteen male Dorper sheep were randomly distributed into three groups (n = 6 each group): group 1, RME with corticotomy on the buccal and palatal sides; group 2, conventional RME treatment; and group 3, no treatment. Post-RME, trabecular bone microstructure and new bone formation were evaluated by using microcomputed tomography (microCT) and histomorphometry after a 4- or 12-week retention period. Intergroup differences in bone quality and bone remodeling were analyzed by using two-way analysis of variance with Bonferroni post-hoc test.
RESULTS
The bone volume fraction (bone volume [BV]/total volume [TV]) values relative to the control in groups 1 and 2 were 54.40% to 69.88% after the 4-week retention period and returned to approximately 80% after the 12-week retention period. The pooled BV/TV values of the banded teeth in groups 1 and 2 were significantly lower than those of the control after the 4-week retention period (p < 0.05). However, after the 12-week retention period, the pooled BV/TV values in group 2 were significantly lower than those in groups 1 and 3 (p < 0.05). Histomorphological analysis showed that the new bone formation area in group 1 was approximately two to three times of those in group 2 and control.
CONCLUSIONS
Corticotomy significantly enhanced the restoration of bone quality after the retention periods for banded teeth. This benefit might result from the increased new bone formation after corticotomy.

Keyword

Corticotomy; Rapid maxillary expansion; Bone microstructure; Microcomputed tomography

MeSH Terms

Bone Remodeling
Humans
Male
Osteogenesis
Palatal Expansion Technique*
Sheep*
Tooth
X-Ray Microtomography*

Figure

• 

  Figure 1 Region of interest (ROI) in quantification of bone microstructure (A) and new bone (NB) and old bone (OB) formation (B1 and B2). A, The furcation enclosed by the buccal and lingual roots of premolars was defined as the ROI (arrow) for measurements of bone microstructure. B, Magnification at hematoxylin and eosin (H&E) stain (×200) showing NB and OB. NB is defined as the amorphous eosinophilic material with porous bone and pale cement lines (black arrow). OB is the bone with a compact feature and prominent cement lines (white arrow) (B1); the total tissue area (outlined by the blue line) at H&E stain (×20) (B2).

• 

  Figure 2 Relative values of bone volume fraction (BV/TV) at the premolar regions compared to the control values in groups 1 (corticotomy + rapid maxillary expansion [RME]) and 2 (conventional RME) after 4 and 12 weeks of retention. P1, First premolar; P2, second premolar; P3, third premolar; 4w, 4-week retention; 12w, 12-week retention.

• 

  Figure 3 A, Relative values of bone volume fraction (BV/TV) values compared to the control values for the banded teeth (the first and third premolars) in groups 1 (corticotomy + rapid maxillary expansion [RME]) and 2 (conventional RME) after 4 and 12 weeks of retention. B, Alveolar trabecular bone microstructural images of group 1 after 4 (B1) and 12 weeks of retention (B3) and of group 2 after 4 (B2) and 12 weeks of retention (B4). C, Histological images at H&E stain (×100) showed that the bone volume in group 1 after 4 and 12 weeks of retention (C1 and C3) were higher than those in group 2 after 4 and 12 weeks of retention (C2 and C4) (H&E stain, ×100). P1, First premolar; P3, third premolar; 4w, 4-week retention; 12w, 12-week retention. *p < 0.05.

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