There have been studies that have shown that it is possible to induce longitudinal bone growth in the jaw even potentially past skeletal maturity. Either the cells of the cartilage of the jaw are different than the cells of other joints(they could express different genes), in which case things that affect the jaw may not affect other joints, or it is not the cells themselves but rather the mechanical environment of the jaw. The jaw undergoes much more dynamic loading than other joints because the jaw is more moveable and the lateral pterygoid muscle is almost directly attached to the cartilage of the jaw providing it with a unique stimulation. Even if the cells of the jaw are different than the cells of other cartilaginous regions it is possible that these cells are different because of the unique mechanical loading that the jaw undergoes. The unique loading that the jaw cartilage undergoes maybe what alters the genetic expression that the cells of the jaw have. It is possible that if we load the joint cartilage of other cartilaginous regions in a similar way we may be able to induce growth longitudinally similar to what occurs in the jaw.
<-already the title is exciting
“A new technique in plastic surgery termed Osteogenesis Modulation is described. This technique uses a surgically implanted, battery-operated medical device to deliver customized electrical pulses to produce mandibular bone growth{trying to surgical implant the device to other joints may be challenging as it could potentially affect movement, we would want a way to implement the electric pulses to other joints in a way that does not require surgery}. This device was designed to be a temporary, nonpermanent implant. The purpose of this study was to review both the safety and efficacy of Osteogenesis Modulation.
This study comprises two phases. Phase I involved experimental technology development and animal experiments. Phase II included technology development for clinical use and a clinical trial. In Phase II, four patients with a diagnosis of mandibular hypoplasia and microgenia underwent surgical implantation of the novel medical device over the chin bone. Once a satisfactory change of contour of mandibular bone was achieved, the devices were removed. In all patients, the devices were left in place for 12 months, then surgically removed under local anesthesia. Preoperative and long-term postoperative cephalometric controls were done.
In all patients, symmetrical mandibular bone growth was observed with good-to-excellent aesthetic results. The overall follow-up period was 39 months. Cephalometric controls taken 3 to 6 months after the device removal showed an average increase in mandible length of 5.26mm (range, 2.83–7.60mm){this increase is not not exciting but it could improved upon}.
Preliminary clinical results suggest that Osteogenesis Modulation is a safe, minimally invasive, and effective alternative treatment for the correction of mandibular hypoplasia in selected cases.”
“he mandible thickness when low-intensity, moderate-intensity, or high-intensity negative pulses were applied was 2.70mm, 3.43mm, and 3.58mm, respectively. The thickness of the mandible on high-intensity positive pulses was 2.15mm.”<-it is very exciting that there was no decrease in results with more stimulus as it means that the stimulation may not be biphasic and it could be possible to increase the results with stronger stimulus.
Here is a before and after xray:
Before and after pic:
There are several before and after pics and x-rays in the study.
The next steps would be to try to apply this to other joints. I would try the hand and toe joints next because they are more movable compared to say the knee and ankle. Even though the stimulus to the jaw is electrical it is still possible that the enhanced jaw movement enhanced the results. Ideally we’d want only the electrical stimulation to produce the results that would make it easier to translate to other joints. That was the problem with possibly trying to mimic the bite jumping appliance on other joints. The jaw just undergoes so much more dynamic loading.
This is a very exciting study and here’s hoping it can translate to cheaper possibly greater height growth than limb lengthening surgery.