J Oral Maxillofac Surg 61:918-927, 2003 Alterations of Morphology and Microdensity in the Condyle After Mandibular Osteodistraction in the Rat Zi Jun Liu, DDS, PhD,* Gregory J. King, DMD, DMSc,† and Susan W. Herring, PhD‡ Purpose: In this study, we examined the effects of mandibular distraction osteogenesis on the morphology and the microdensity of the rat condyle. Materials and Methods: One hundred twenty-nine rats were allocated to 4 experimental groups (n = 32 or 33). Each received unilateral mandibular ramus osteotomy and distraction device placement. After a 3-day latency, these were distracted once a day for 5 days. The slow distraction group was distracted a total of 1 mm (0.2 mm/d); the moderate group, 2 mm (0.4 mm/d); the rapid group, 3 mm (0.6 mm/d); and the sham group, no distraction (0.0 mm/d). Eight to 9 rats in each group were sacrificed at each of 4 time points after device placement (6, 10, 24, and 38 days). Baseline data were obtained 3 days after osteotomy and device placement without distraction from an additional 10 rats. Radiographs of the hemimandibles were scanned and measured to evaluate changes in condylar size (height, width, and area), angulation, and bone microdensity converted to equivalent bone thickness using a stepwedge. The wet weights of masseter muscle were measured at the time of harvest. Results: 1) Muscle weight gains over time were significantly lower in the treated than the untreated sides throughout the consolidation period (P .001). 2) Condylar size and angulation on the untreated side increased postoperatively, whereas there was a significant reduction of these parameters (P .01 to .001) on the treated side at 24 and/or 38 days. 3) Condylar microdensity significantly increased on the untreated side at 24 and 38 days (P .05 to .01) but not on the treated side. 4) Faster or larger distraction caused more severe size reduction and more upright condylar angulation, prevented an increase in bone microdensity on the treated side, especially during the consolidation periods (P .05 to .01), and retarded increase in muscle weight, whereas a slower distraction rate showed few negative, and even some positive effects. 5) Correlations in size, angulation, and microdensity between right and left condyles became less significant over time. 6) There were positive correlations between muscle weight and condylar size, angulation, and microdensity. Conclusion: An increased rate of mandibular distraction has significant negative effects on condylar morphology and microdensity. © 2003 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 61:918-927, 2003 As a dynamic method for generating new bone, dis- traction osteogenesis has been widely accepted as the treatment of choice for the surgical correction of hypoplasias of the craniofacial skeleton. However, the procedure can be difficult to control and its side effects are not well understood. 1 In osteodistraction, a tensile force is applied across an osteotomy to lengthen a bone. The forces produced by the distrac- tion maneuvers are superimposed on the normal me- chanics of the bone, and thus put unusual loads on the entire craniofacial skeleton, which could alter the process of normal growth and/or adaptive remodel- ing in the region. Some have raised concerns about undue loading of joints during lengthening of long bones by distrac- tion. 2,3 Early surgery for distraction may also retard the growth potential of the mandible and its associ- ated soft-tissue structures. 4 When the mandible is Received from the Department of Orthodontics, University of Washington, Seattle, WA. *Assistant Professor. †Professor and Chair. ‡Professor. This work was supported by National Institute of Dental and Craniofacial Research Grant DE13061. Address correspondence and reprint requests to Dr Liu: Depart- ment of Orthodontics, Box 357446, University of Washington, Seattle, WA; e-mail: zjliu@u.washington.edu © 2003 American Association of Oral and Maxillofacial Surgeons 0278-2391/03/6108-0092$30.00/0 doi:10.1016/S0278-2391(03)00294-5 918