The Effect of Decortication for Periosteal Expansion Osteogenesis Using Shape Memory Alloy Mesh Device

Background: In conventional bone grafting technique, decortication procedure enhances the healing process and bone regeneration to reach the grafted site more readily. Purpose: This study evaluates to improve periosteal expansion osteogenesis (PEO) using a shape memory alloy mesh (SMA) device with decortication in a rabbit model. Materials and Methods: The SMA device was inserted under the periosteum at the forehead and pushed, bent, and attached to the bone surface and fixed with a titanium screw. Twelve rabbits were divided into two groups: PEO without decortication (P group) and with decortication (D group). After 2 weeks, the screw was removed, and the mesh was activated by its own elasticity. Rabbits were sacrificed 5 (P1/D1) and 8 (P2/D2) weeks after operation and histologically and radiographically evaluated. Results: The mean activation height was 2.9±0.5mm. The ratio of new bone volume in the elevated volume was 17.6% in P1, 59.8% in D1 33.4% in P2, and 65.1% in D2. D group had a statistically higher volume of new bone than P group during each period (p<.05). Conclusion: PEO with decortication appears to be a promising clinical alternative for bone augmentation and introduces the new concept of "dynamic graft and guided bone regeneration (GBR)."