We’re willing to bet that if you aren’t a student of dentistry, you’ve never heard of distraction osteogenesis. It’s one of the many procedures performed at Sedaros Oral Surgery, and today we’d like you to get familiar with the procedure and what it has to offer.
Distraction Osteogenesis is only used for selected deformities and defects of the oral and facial bones. The surgeon slowly moves two segments of bone tissue apart from one another with an appliance (this is the “distraction”–or moving apart–of the procedure). As the bone is separated, it’s done so carefully so as to leave just enough space between the segments that new bone can fill in the gaps. Leaving room for the bone to regenerate is the “osteogenesis” of the procedure.
Distraction osteogenesis was first used in 1903 and was used primarily to lengthen the arm and leg bones. The treatment of the facial and oral skeleton with distraction osteogenesis begin in the 1990s and since then the field has become safe and predictable for treatment of certain deformities and defects of the facial bones.
For young children with facial deformities, the bones are moved apart and then held in place considering where the new bone should form. The patient is sent home with a “distractor” that can continue to move the bone apart following surgery and as new bone forms. The parent will turn the distrator usually 1mm per day to keep the bones moving apart while new bone forms in the gaps. The pain is comparable to braces in older children. It’s unfortable and achy, but manageable.
After a period of about two months, the distractor can be removed in a second surgery and the new bone is in place for life. Advances in the technology of distraction osteogenesis have made this procedure less painful, while becoming more and more suitable for treating those disorders. It eliminates the need for bone grafts and produces less swelling than traditional treatments. However, the frequent monitoring of the bone in the weeks after the appliance is placed by the surgeon can be a disadvantage for the patient.
What conditions are treated with distraction osteogenesis?
Dr. Sedaros can use distraction osteogenesis to treat:
- Adolescents with cleft palate when their upper jaw has not grown properly (Le Fort I maxillary advancement)
- Younger children with Crouzon, Apert or other craniosynostosis syndromes when their entire upper face has not developed properly (Le Fort III midface advancement)
- Children of any age, from newborn to teenager, when their lower jaw has not formed properly and is causing problems (mandible or lower jaw distraction)
In any case where the mandible, maxilla, or portions of the upper and lower jaw aren’t aligned, distraction methods can create a potential solution. The outcomes are always customized to the individual’s facial structure and the desired bone structure outcome.
To be a candidate for distraction osteogenesis, the patient must be otherwise healthy, must grow bone normally and must have the underlying nutritional stores to support the development of new bone. In addition, a patient must be supported by caregivers who can monitor the distraction process, and must be willing to manipulate the distractor during the process.
The final outcome of distraction osteogenesis is bone structure much closer to the “normal” facial structure without having to undergo multiple surgeries and without foreign bodies implanted with the facial structure.
Distraction osteogenesis may sound scary, but it’s really a simple procedure that maximizes the way bone naturally grows to remedy facial deformities. It’s a procedure that uses the process of bone development to allow a patient to grow his or her own biological tissue in place without having multiple procedures.
If you have a referral for distraction osteogenesis or would like to learn more about the procedure at Sedaros Oral Surgery, contact us today for more details!