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Distraction osteogenesis (DO) is a relatively new method of treatment for selected deformities and defects of the oral and facial skeleton. It was first used in 1903. Then, in the 1950’s the Russian orthopedic surgeon, Dr. Gabriel Ilizarov slowly perfected the surgical and postoperative management of distraction osteogenesis treatment to correct deformities and repair defects of the arms and legs. His work went mostly unnoticed until he presented to the Western Medical Society in the mid-1960’s.
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Distraction osteogenesis was initially used to treat defects of the oral and facial region in 1990. Since then, the surgical and technological advances made in the field of distraction osteogenesis have provided the oral and maxillofacial surgeons with a safe and predictable method to treat selected deformities of the oral and facial skeleton.
Distraction osteogenesis is done by creating an osteotomy (a bone cut) in the bone in a special way to create a “block” of bone which can be moved. A special device must be fashioned to fit the bone. This “distractor” uses a simple mechanical method to pull the bones apart at a very precise rate (usually 1 mm increase per day). As the bones are pulled apart at the osteotomy (bone cut) new bone grows in the gap.
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Dr. Reynolds uses distraction osteogenesis to treat selected deformities and defects of the oral and facial skeleton.
In the oral and maxillofacial region there are two main types of distractors; ones that distract an entire bone and ones that distract a segment such as the tooth bearing bone. Distraction osteogenesis can be used to move or lengthen the jaws. In cases of very large movements or cases with scaring in the surrounding tissues, as in cleft lip and palate, distraction is the method of choice.
When distraction is used for the tooth bearing bone (alveolar bone) the resultant bone can be used for implant placement to restore missing dentition.
Alveolar Distraction Osteogenesis
Alveolar distraction is distraction of the tooth bearing bone, alveolar bone. This is usually done after tooth loss has resulted in atrophy of the bone. The loss of bone may also be due to trauma or disease. The goal of distraction in the case of alveolar distraction is to provide bone for future implant placement.
Orthognathic Distraction Osteogenesis
Distraction osteogenesis for orthognathic surgery uses distraction techniques with specialized devices to move or lengthen the jaw bones or facial bones. The advantage to traditional techniques is that it can be done over much longer distances and can be used in patients who have scarring of the surrounding tissues, such as cleft lip and palate patients. The disadvantage is that the devices must be removed. Examples of device for orthognathic distraction osteogenesis;
(Pictures courtesy of KLS Martin)
Frequently Asked Questions about Distraction Osteogenesis
To preview Pre-Operative Instructions, Consent and Post-Operative Instructions along with the scheduled visits, see “Doc’s Orders; Distraction Osteogenesis”.
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