Distraction osteogenesis (DO) is a relatively new method of treatment for selected deformities and defects of the jaw and skull. Although it was first used in 1903, in the 1950s the Russian orthopedic surgeon, Dr. Gabriel Ilizarov, slowly perfected the surgical and postoperative management of distraction osteogenesis treatment to correct deformities and repair defects in the arms and legs. His work went mostly unnoticed until he presented to the Western Medical Society in the mid-1960s.
Distraction osteogenesis was first 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 oral and maxillofacial surgeons with a safe and predictable method to treat selected deformities.
If you have questions about distraction osteogenesis, please call our office and schedule an appointment with Dr. Auble to Dr. Gresehover.
Our team 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 the 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 a device for orthognathic distraction osteogenesis;
(Pictures courtesy of KLS Martin)
Frequently Asked Questions About Distraction Osteogenesis
What does the term distraction osteogenesis mean? Simply stated, distraction osteogenesis means the slow movement apart (distraction) of two bony segments in a manner such that new bone is allowed to grow and fill in the gap created by the separating bony segments.
Is the surgery for distraction osteogenesis more involved than “traditional surgery” for a similar procedure? No. Distraction osteogenesis surgery is usually done on an outpatient basis with most of the patients going home the same day of surgery. The surgical procedure itself is less invasive so there is usually less pain and swelling.
Will my insurance company cover the cost of osteogenesis surgical procedure? Most insurance companies will cover the cost of the osteogenesis surgical procedure provided that there is adequate and accurate documentation of the patient’s condition. Of course, individual benefits within the insurance company policy vary. After you are seen for your consultation at our office, we will assist you in determining whether or not your insurance company will cover a particular surgical procedure.
Is distraction osteogenesis painful? Since all distraction osteogenesis surgical procedures are done while the patient is under general anesthesia, pain during the surgical procedure is not an issue. Postoperatively, you will be supplied with appropriate analgesics (pain killers) to keep you comfortable, and antibiotics to fight off infection. Activation of the distraction device to slowly separate the bones may cause mild discomfort. In general, the slow movement of bony segments produces discomfort roughly similar to having braces tightened.
What are the benefits of distraction osteogenesis vs. traditional surgery for a similar condition? Distraction osteogenesis surgical procedures typically produce less pain and swelling than the traditional surgical procedure for a similar condition. Distraction osteogenesis eliminates the need for a second surgical site to harvest bone graft material. Lastly, distraction osteogenesis is associated with greater stability when used in major cases where significant movement of bony segments is involved.
What are the disadvantages of distraction osteogenesis? Distraction osteogenesis requires the patient to return to the surgeon’s office frequently during the initial two weeks after surgery. This is necessary because in this time frame the surgeon will need to closely monitor the patient for any infection and teach the patient how to activate the appliance. In some cases, a second minor office surgical procedure is necessary to remove the distraction appliance.
Can distraction osteogenesis be used instead of bone grafts to add bone to my jaws? Yes. Recent advances in technology have provided the oral and maxillofacial surgeon with a distraction device that can be used to slowly grow bone in selected areas of bone loss that has occurred in the upper and lower jaws. The newly formed bone can then serve as an excellent foundation for dental implants.
Does distraction osteogenesis leave scars on the face? No. The entire surgery is performed within the mouth and the distraction devices used by our team remain inside the mouth. There are no facial surgical incisions made, therefore, no facial scars result.
Are there any age limitations for patients who can receive osteogenesis? No. Distraction osteogenesis works well on patients of all ages. In general, the younger the patient the shorter the distraction time and the faster the consolidation phase. Adults require a slightly longer period of distraction and consolidation because the bone regenerative capabilities are slightly slower than those of adolescence or infants.
WHY Reynolds oral and facial surgery?
Reynolds Oral and Facial Surgery is one of the best oral and facial surgery teams around. With more than 20 years of experience and extensive training, we know what it takes to make sure your procedure runs smoothly. Dr. Reynolds and Dr. Gresehover have a keen eye for detail and strive to make sure to answer any questions you may have. Our team understands that medical procedures can be very nerve-racking experiences which is why we make sure you are comfortable and have the best experience possible. We also invest heavily in the most advanced surgical technology available ensuring you get the best results possible.