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The objective of this systematic review was to synthesize all the preclinical studies carried out in periosteal distraction osteogenesis (PDO) in order to evaluate the quality using the ARRIVE guidelines. The animal models used, and the influence of the complications, were analysed in order to establish the most appropriate models for this technique. The PRISMA statements have been followed. Bibliographic sources have been consulted manually by two reviewers. Risk of bias was evaluated using the SYRCLE tool for animal studies, and the quality of the studies with the ARRIVE 2.0 guidelines. The selection criteria established by expert researchers were applied to decide which studies should be included in the review, that resulted in twenty-four studies. Only one achieved the maximum score according to the ARRIVE 2.0 guidelines. The rabbit as an animal model has presented good results in PDO, both for calvaria and jaw. Rats have shown good results for PDO in calvaria. The minipig should not be recommended as an animal model in PDO. Despite the increase in the quality of the studies since the implementation of the ARRIVE 2.0 guidelines, it would be necessary to improve the quality of the studies to facilitate the transparency, comparison, and reproducibility of future works.

For a world that is constantly trying to speed up every procedure while obtaining the maximum result, traditional orthodontics have the biological limitation of using light and constant forces that allow tooth movement in a time frame that is only sometimes short. The treatment time could be lengthened if surgical procedures are programmed in the plan. Methods to accelerate tooth movement and reduce the duration of treatment while minimising complications are investigated and reported in the dental literature (e.g., low-level laser therapy, corticotomy, and micro-osteoperforations). This systematic review aims to analyse and summarise the strategies for quickening orthodontic movement during extraction orthodontic treatment, including any potential drawbacks or adverse consequences. The review will evaluate each approach’s effectiveness, safety, and evidence quality, compare their benefits and disadvantages, and analyse the implications for clinical practice and future research. Pubmed, Science Direct, Scopus, and Web of Science were searched using the keywords “acceleration” AND “dental movement” AND “orthodontic” between 1 April 2003 and 1 April 2023. After carefully scanning the study findings, forty-four publications were chosen for the systematic review. Most therapies discussed and provided in the literature seem promising and successful in enhancing orthodontic treatments. The success of operations like corticotomies, piezo-incisions, micro-osteoperforations, osteogenic distraction, low-level laser therapy, the administration of pharmacological treatments, and infiltrations with PRF and PRP were statistically significant and appear to be promising and effective in optimising orthodontic treatments. These strategies expedite treatment and enhance the patient experience, potentially broadening orthodontic appeal and minimising issues like cavities and enamel demineralisation. Further studies, with larger samples and standardised treatment protocols, are needed to investigate the efficacy of these tooth movement acceleration modalities.

Alveolar osteogenic distraction (AOD) is a biological process through which new bone formation occurs between bone segments that are gradually separated by incremental traction. This case report described the oral rehabilitation with dental implants of a patient with a vertical bone defect in the maxillary anterior region using the AOD technique. The patient presented with absence of the teeth 22, 21, 11, and 12 associated with a vertical bone defect. The AOD was performed using a supported osteodistractor device surgically installed with subsequent daily activations. After 21 days, the ideal positioning of bone fragment was confirmed and activation was ceased. Five months after the initial surgery, two dental implants were installed in the region of teeth 12 and 22. An FP3 metal-ceramic prosthesis was installed offering satisfactory esthetic results. In conclusion, the use of AOD to increase the alveolar ridge was effective and ensured rehabilitation with dental implants.

La distracción osteogénica es un proceso biológico de neo formación ósea a partir de dos segmentos oseos previamente osteotomizados que se separan en forma gradual debido a una tracción mecánica incremental generada por un tornillo distractor. El proceso biológico da inicio cuando las fuerzas de distracción posteriores a un periodo de latencia, se aplican sobre la matriz colágena que forma el callo óseo entre los segmentos de hueso seccionados,estimulando de esta forma la neoformacion ósea paralela al vector de distracción. Esta alternativa quirúrgica ha sido por décadas empleada para el alargamiento de extremidades, especialmente de huesos largos. Actualmente es utilizada con múltiples propósitos en el complejo maxilofacial, ofreciendo la posibilidad de modular la cantidad de hueso y demás tejidos blandos de los maxilares y de esta manera restableciendo su arquitectura en cualquier plano del espacio obteniendo muy buenos resultados. Este reporte de caso presenta la distracción osteogénica alveolar (DOA) como alternativa para el tratamiento de recidivas, secundarias a la corrección quirúrgica de discrepancias Maxilomandibulares clase II mediante la técnica osteotomía sagital de rama mandibular (OSRM) de avance; en pacientes donde no es posible una segunda intervención quirúrgica. Palabras clave: Distracción osteogenica, Tratamiento quirúrgico maloclusiones esqueléticas clase II, Estabilidad esquelética avance mandibular, Recidiva cirugía ortognatica. Osteogenic distraction is a biological process of osseous neoformation from two segments previously subjected to osteotomy which are separated in a gradual form by an incremental mechanical traction generated by a distracting screw. The biological process begins when posterior distraction forces are applied after a latency period on a collagenous matrix which forms a bony callous between the sectioned bone fragments stimulating in this form bone neoformation parallel to the distraction vector. This surgical alternative has been used for decades in the lengthening of limbs, especially in long bones. Currently it is used for multiple purposes in the craniofacial complex offering the possibility of modeling the amount of bone and surrounding soft tissues and in this way reestablishing its architecture in any spatial plane and obtaining very good results. A case report is presented of an alveolar bone distraction as an alternative for the treatment of relapse secondary to surgical correction of Class II maxillofacial discrepancies with advanced sagittal osteotomy of the mandibular ramus in patients in which a second surgical intervention is not possible. Key words: Osteogenic distraction, Orthognathic surgery, Class II malocclusions, Mandibular advancement, Skeletal stability, Relapse.

Background: Total flavonoids of Rhizoma Drynariae (TFRD), extracted from the kidney-tonifying traditional Chinese medicine Rhizoma Rrynariae, has been proved to be effective in treating osteoporosis, bone fractures and defects. However, pharmacological effects of TFRD on type H vessels, angiogenic-osteogenic coupling in distraction osteogenesis (DO) and the mechanism remain unclear. This study aims at investigating whether type H vessels exist in the DO model, effects of TFRD on angiogenic-osteogenic coupling and further elucidating the underlying mechanism. Methods: Rats models of DO and bone fracture (FR) were established, and then were separately divided into TFRD and control subgroups. Imageological and histological analyses were performed to assess bone and vessel formation. Immunofluorescent staining of CD31 and endomucin (Emcn) was conducted to determine type H vessel formation. Matrigel tube formation, ALP and Alizarin Red S staining assays were performed to test the effects of TFRD on angiogenesis or osteogenesis of endothelial precursor cells (EPCs) or bone marrow-derived mesenchymal stem cells (BMSCs). Additionally, expression levels of HIF-1α, VEGF, PDGF-BB, RUNX2 and OSX were determined by ELISA, qPCR or western blot, respectively. Results: The in vivo results indicated more formed type H vessels in DO groups than in FR groups and TFRD obviously increased the abundance of type H vessels. Moreover, groups with higher abundance of type H vessels showed better angiogenesis and osteogenesis outcomes. Further in vitro experiments showed that TFRD significantly promoted while blocking PDGF-BB remarkably suppressed the angiogenic activity of EPCs under stress conditions. The levels of p -AKT and p -ERK1/2, downstream mediators of the PDGF-BB pathway, were up-regulated by TFRD but blocked by function blocking anti-PDGF-BB antibody. In contrast, the activated AKT and ERK1/2 and corresponding tube formation were not affected by the HIF-1α inhibitor. Besides, blocking PDGF-BB inhibited the osteogenic differentiation of the stretched BMSCs, but TFRD enhanced the osteogenic activity of BMSCs and ameliorated the inhibition, with more calcium nodes, higher ALP activity and mRNA and protein levels of RUNX2 and OSX. Conclusion: Type H vessels exist in the DO model and TFRD enhances angiogenic-osteogenic coupling during DO by promoting type H vessel formation via PDGF-BB/PDGFR-β instead of HIF-1α/VEGF axis.

Distraction osteogenesis (DO) is used to treat specific disorders associated with growth abnormalities and/or loss of bone stock secondary to trauma or disease. However, a high rate of complications and discomfort hamper its further application in clinical practice. Here, we investigated the effects of all-trans retinoic acid (ATRA) on osteogenic differentiation of rat bone marrow-derived mesenchymal stem cells (rBMSCs) and bone consolidation in a rat DO model. Different doses of ATRA were used to treat rBMSCs. Cell viability and osteogenic differentiation were assessed using CCK-8 and alkaline phosphatase staining, respectively. The mRNA expression of osteogenic differentiation-genes (including ALP, Runx2, OCN, OPN, OSX, and BMP2) and angiogenic genes (including VEGF, HIF-1, FLK-2, ANG-2, and ANG-4) were determined by quantitative real-time PCR analysis. Further, we locally injected ATRA or PBS into the gap in the rat DO model every 3 days until termination. X-rays, micro-computed tomography (Micro-CT), mechanical testing, and immunohistochemistry stains were used to evaluate the quality of the regenerates. ATRA promoted osteogenic differentiation of rBMSCs. Moreover, ATRA elevated the mRNA expression levels of osteogenic differentiation-genes and angiogenic genes. In the rat model, new bone properties of bone volume/total tissue volume and mechanical strength were significantly higher in the ATRA-treatment group. Micro-CT examination showed more mineralized bone after the ATRA-treatment, and immunohistochemistry demonstrated more new bone formation after ATRA-treatment than that in the PBS group. In conclusion, as a readily available and very cost effective bio-source, ATRA may be a novel therapeutic method to enhance bone consolidation in the clinical setting.

Background This randomized clinical trial was designed to evaluate osteogenic potential of Cissus quadrangularis in alveolar distraction to facilitate implant installation. Material and methods Twenty patients with atrophic ridge were treated by alveolar distraction. After completing distractor activation, patients were randomly divided into two equal groups according to administered drug (placebo and Cissus quadrangularis group). After a consolidation period, distractors were removed and implants were inserted. Clinical evaluation was done to assess wound healing, and distractor and implant stability. Histological evaluation was performed at time of implant insertion. Radiographic evaluation was performed to assess bone volume and density after distraction, as well as, density and bone loss around implant. Results Radiographic and histological results showed that bone formation and maturation of study group were faster than that of control group. There was a significant increased bone density in distracted area and around implant in study group than control group. A significant bone loss at end of consolidation period, and around implant at end of the study was reported in control group than study group. Conclusion Cissus quadrangularis administration during the consolidation period is associated with increased osteogenic potential of distracted bone. The histological and radiographic findings of current study proved that Cissus quadrangularis not only enhances rate of new bone formation, but also bone density to withstand the biomechanical requirements of implant placement in a shorter time. Trial registration This study was retrospectively registered on www.ClinicalTrial.gov : NCT04669795-17\\12\\2020.

Distraction osteogenesis (DO) represents a promising approach for treating large bone defects, yet prolonged consolidation periods limit clinical efficacy, and the molecular mechanisms underlying neuropeptide regulation of bone regeneration remain poorly understood. We systematically investigated calcitonin gene-related peptide (CGRP)-dependent molecular signaling effects on rat bone marrow mesenchymal stem cells (BMSCs) through comprehensive in vitro analyses and evaluated therapeutic efficacy in a rat femoral DO model (n = 108). CGRP (10 −8  M) significantly enhanced BMSC proliferation, migration, and osteogenic differentiation while reducing apoptosis by 47%. Molecular analysis revealed rapid cyclic adenosine monophosphate (cAMP) elevation (2.3-fold within 30 min) and subsequent PKA/CREB pathway activation, upregulating key osteogenic genes ( Runx2 , Sp7 , Spp1 , and Bglap ). The CGRP receptor antagonist and the PKA inhibitor completely abolished these effects, confirming pathway dependence. In vivo , local CGRP treatment accelerated bone formation, improving bone mineral density (1.8-fold), trabecular microarchitecture, and biomechanical properties, including ultimate load (89% increase) and stiffness (76% increase), compared to controls. These findings demonstrate that CGRP-dependent molecular signaling drives bone marrow stem cell osteogenesis through cAMP/PKA/CREB activation, providing mechanistic insights into neuropeptide regulation of bone regeneration and identifying CGRP as a promising therapeutic target for optimizing distraction osteogenesis outcomes.

We present an adolescent with distal radius nonunion following an open fracture and failed surgery which eventually united when the length andstability was restored for eight weeks duration. The intact periosteal sleeve at the nonunion site formed new bone when its tension was restored by gradual differential distraction. This case report highlights the possibility ofstimulating bony union in an established atrophic nonunion by distracting the minimally disturbed soft tissue and thick osteogenic periosteal envelope in the paediatric age group.