Distraction Osteogenesis

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 slowly perfected the surgical and postoperative management of distraction osteogenesis treatment to correct deformities and repair defects of the arms and legs.

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 a surgical process used to reconstruct skeletal deformities and lengthen the bones of the body. A corticotomy is used to fracture the bone into two segments, and the two ends of the bone are gradually moved apart during the distraction phase, allowing new bone to form in the gap. When the desired or possible length is reached, a consolidation phase follows in which the bone is allowed to keep healing. Distraction osteogenesis has the benefit of simultaneously increasing bone length and the volume of surrounding soft tissues.
Since all distraction osteogenesis surgical procedures are done while the patient is under general anesthesia, pain during the surgical procedure is not an issue.. Activation of the distraction device to slowly separate the bones may cause some patients mild discomfort. In general, the slow movement of bony segments produces discomfort roughly analogous to having braces tightened.

Benefits of Distraction Osteogenesis:

  • 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 bone grafts, and therefore, another surgical site.
  • Lastly, distraction osteogenesis is associated with greater stability when used in major cases where significant movement of bony segments are involved.
  • 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.

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.