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Distraction Osteogenesis
Assessment of the distraction regenerate using three-dimensional quantitative computer tomography

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Abstract

This study presents a new method for objective assessment of the distraction regenerate using three-dimensional quantitative computer tomography (3D-QCT). The distraction specimens of 16 sheep that underwent bifocal cranial distraction osteogenesis to reconstruct a critical size defect were used to evaluate this method. To analyse the validity of this method the results were compared to conventional quantitative computer tomography (QCT). Squared correlation coefficients (r2) according to Sackett showed a high reliability (r2>70% for the total DO regenerate, DO Regions 2–4). Method comparison according to Bland-Altman (≤6.25% of measurements out of 95% limits of agreement) showed that three-dimensional computer tomography based bone densitometry is valid for future DO research.

Section snippets

Material and methods

The distraction specimens of 16 sheep that underwent bifocal cranial DO to reconstruct a critical size defect (CSD) were used for this study. The experimental protocol is described in another publication48. After removal of all fixation pins and plates, all specimens were scanned following a strict protocol coronally at 120 kV and 80 mA (CT Light Speed QX/i, General Electric®). Scanning was performed in Head field at a table speed of 3.75 mm per rotation (1.0 s per rotation). The slice thickness

Results

Results of mean density measurements of the total regenerate made by conventional QCT (Osiris® software, version 3.1) and 3D-QCT (Maxilim™ software, version 1.2.0) are expressed in HU and as a percentage of the host cranial bone in Fig. 8 and Fig. 9, respectively. Results of method comparison tests according to Sackett et al.40 and Bland & Altman6., 9. are summarized in Fig. 10, Fig. 11, respectively. As far as method comparison testing according to Sackett et al.40 was concerned, squared

Discussion

New bone formation during the early phase of DO predicts later mineralization and mineralization of the regenerate continues well after lengthening has been completed31. Attempts of quantification of the process of bone mineralisation are based on the fact that the maturation process of the regenerate which is called mineralization can be quantitated by radiodensity changes because calcium, the primary mineral absorbs X-rays at characteristic wavelengths3. The most common imaging method to

Acknowledgements

The authors thank Professor Dr. Hartmut Hecker (Department of Biometry, Hannover Medical University) for his assistance in the statistical analysis of the data and Ms. Uttenwald (Department of Neuroradiology, Hannover Medical University, Head: Professor Dr. C. Becker) for scanning the DO specimens.

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    Copyright © 2004 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.