Reconstruction of mandibular condyle by transport distraction osteogenesis: Experimental study in rhesus monkey

Purpose: This study investigated histomorphologic changes in the newly formed condyle reconstructed by transport distraction osteogenesis through a nonhuman primate model. Materials and Methods: Six adult rhesus monkeys were used in this study. Bilateral condyles and articular discs were extirpated, and the technique of transport distraction osteogenesis was carried out to reconstruct the condyles. X-ray and 3-dimensional (3D) computed tomography (CT) scanning films were taken at various intervals. Two monkeys were killed respectively at 4, 12, and 24 weeks after completion of distraction; the transport segments and the distracted calluses were harvested and processed for histologic examination. The original condyles removed at surgery served as normal control. Results: Open bite was seen in all animals postoperatively and diminished at the end of distraction. Bone regeneration was perfect in the distraction gap between the transport disc and the pre-existing mandible. The bony transport disc gradually remodeled to a neocondyle that was similar to the original condyle in the appearances and structures. The head of neocondyle was covered with a fibrous cap, which might play the role of an articular disc. Conclusion: A neocondyle with functional shape can be created by transport distraction osteogenesis. This suggests that this technique is an alternative method for reconstruction of the mandibular condyle. (C) 2006 American Association of Oral and Maxillofacial Surgeons.