Effects of hyperbaric oxygen therapy on an accelerated rate of mandibular distraction osteogenesis

Background: Distraction osteogenesis has become a standard therapy for lengthening of the human craniofacial skeleton. Because the technique is used predominately in a paediatric population, limiting the treatment protocol is beneficial. Methods: Twenty-four animals were divided into four groups with distraction rates of 1 mm and 2 mm/day with and without hyperbaric oxygen (HBO) therapy. Following a 5-day latency period, mandibular lengthening of 15 mm was performed with a uniaxial distractor along the body of the mandible. Consolidation period was 4 weeks in all groups. HBO therapy was administered to one of the 1 and 2 mm/day groups 1 day preoperatively, throughout the latency and distraction phases and 2 weeks into the consolidation period. Animals were euthanised after consolidation and the mandibles harvested for bone mineral densitometry evaluation. Results: The mean bone mineral density (BMD) (g/cm(2)) was 0.208 +/- 0.04 in Group 1 (1 mm/day distraction, no HBO therapy), 0.228 +/- 0.09 in Group 2 (1 mm/day distraction, + HBO therapy), 0.180 +/- 0.1 in Group 3 (2 mm/day distraction, no HBO therapy), and 0.269 +/- 0.05 in Group 4 (2 mm/day distraction, + HBO therapy). Using the Student's t-test for equality of means and the one-way analysis of variance (ANOVA), we found that the mean BMD was significantly higher in the groups that were administered HBO (Groups 2 and 4) than not (P = < 0.05). For the groups that had distraction of 1 mm/day and 2 mm/day, those that underwent HBO therapy had significantly higher BMD than those without HBO therapy ( P = < 0.05). Conclusion: We have found that HBO therapy may serve to augment the healing process in distraction osteogenesis, allowing for more rapid distraction in order to decrease the overall treatment time. (C) 2008 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.