REVIEW Enhancement of bone consolidation in mandibular distraction osteogenesis: A contemporary review of experimental studies involving adjuvant therapies Paul Hong a,b, *, Daniel Boyd c , Steven D. Beyea d,e , Michael Bezuhly a a IWK Health Centre, Dalhousie Pediatric Craniofacial Group, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada b School of Human Communication Disorders, Dalhousie University, Halifax, Nova Scotia, Canada c Department of Applied Oral Sciences, Biomaterials and Oral Biology, Dalhousie University, Halifax, Nova Scotia, Canada d Department of Radiology, Dalhousie University, Halifax, Nova Scotia, Canada e Institute for Biodiagnostics (Atlantic), National Research Council of Canada, Halifax, Nova Scotia, Canada Received 30 August 2012; accepted 16 March 2013 KEYWORDS Distraction osteogenesis; Mandible; Consolidation; Growth factors; Hormones; Stem cells; Gene therapy; Adjuvant therapy Summary Background: One of the major disadvantages of mandibular distraction osteogen- esis (MDO) is the prolonged time required for consolidation of the regenerate bone. The objec- tive of the present study is to perform a contemporary review of various adjuvant therapies to enhance bone consolidation in MDO. Methods: A PubMed search for articles related to MDO, along with the references of those ar- ticles, was performed. Inclusion and exclusion criteria were applied to all experimental studies assessing adjuvant therapies to enhance bone consolidation. Results: A total of 1414 titles and abstracts were initially reviewed; 61 studies were included for full review. Many studies involved growth factors, hormones, pharmacological agents, gene therapy, and stem cells. Other adjuvant therapies included mechanical stimulation, laser Abbreviations: bFGF, basic fibroblast growth factor; BM, bone marrow; BMC, bone mineral content; BMD, bone mineral density; BMP, bone morphogenetic protein; CT, computed tomography; CaOH, calcium hydroxide; CaSO 4 , calcium sulfate; DNA, deoxyribonucleic acid; ESWT, extracorporeal shock wave therapy; GF, growth factor; GH, growth hormone; GaAlAs, gallium-aluminum-arsenide; HA, hyaluronic acid; HBO, hyperbaric oxygen; IGF, insulin-like growth factor; LIPUS, low-intensity pulsed ultrasound; LLL, low-level laser; MicroCT, micro- computed tomography; MDO, mandibular distraction osteogenesis; MMP, matrix metalloproteinase; MSC, mesenchymal stem cell; PBS, phosphate buffered solution; PRP, platelet rich plasma; TGF, transforming growth factor; TIMP, tissue inhibitor of matrix metalloproteinase; VEGF, vascular endothelial growth factor. * Corresponding author. IWK Health Centre, 5850/5980 University Avenue, PO Box 9700, Halifax, Nova Scotia B3K 6R8, Canada. Tel.: þ1 902 470 0841; fax: þ1 902 470 8929. E-mail address: Paul.Hong@iwk.nshealth.ca (P. Hong). + MODEL Please cite this article in press as: Hong P, et al., Enhancement of bone consolidation in mandibular distraction osteogenesis: A contemporary review of experimental studies involving adjuvant therapies, Journal of Plastic, Reconstructive & Aesthetic Surgery (2013), http://dx.doi.org/10.1016/j.bjps.2013.03.030 1748-6815/$ - see front matter ª 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.bjps.2013.03.030 Journal of Plastic, Reconstructive & Aesthetic Surgery (2013) xx,1e13