Distraction Osteogenesis

Distraction osteogenesis is a surgical method that corrects skeletal deformities and repairs defects by forming new bone tissue. First developed in the early 1900s, the procedure was refined and improved in the 1950s and 1960’s thanks to the efforts of the Russian orthopedic surgeon, Dr. Gabriel Ilizarov. While initially limited to the surgical correction of skeletal deficiencies in the arms and legs, in the past few decades, distraction osteogenesis has emerged as a safe and predictable technique for the treatment of a wide range of craniofacial and jaw defects. 

About distraction osteogenesis and why it’s performed

Distraction osteogenesis is a surgical method used to generate new bone while making a shorter bone significantly longer. It’s based upon the “tension-stress” principle. By cutting the involved bone, then gradually and gently distracting the two segments, a biological response to create new bone in the developed space is stimulated. Distraction osteogenesis produces stable, functional, and aesthetically pleasing results of care. 

 A distraction osteogenesis procedure is an excellent option in cases involving moderate to severe bone defects such as those associated with certain craniofacial syndromes, a deficient upper jaw and depressed midface, an underdeveloped and recessed lower jaw, or to reconstruct the alveolar ridge to support dental implants. 

What to expect of the procedure

A Distraction osteogenesis surgery is usually done on an outpatient basis, with most patients going home the very same day. The procedure, which is performed under general anesthesia, involves cutting the bone via a corticotomy, or an osteotomy, and then placing the distraction appliances as indicated. Because distraction osteogenesis is not as invasive as other types of surgery, post-operative swelling and pain are typically less than other procedures. Following surgery, appropriate pain control medications to help ensure patient comfort and antibiotics to ward off potential infection are provided. 

Because the procedure is performed within the mouth; there’s no extraoral or facial scarring. And, since the distraction devices are placed internally at the surgical site, there’s also no need for a highly visible, ungainly and uncomfortable external armature while the bone is gradually being distracted. 

The only caveat with distraction osteogenesis is the requirement that patients come in for frequent visits in the two weeks following the procedure. In this way, our our office can closely monitor post-op healing and provide detailed instructions on how to activate the distraction device. 

The distraction process is performed gradually. With a distraction rate of .5mm to 1mm per day, patients described their level of discomfort as being comparable to getting dental braces adjusted. 

Distraction osteogenesis or bone grafts?

While many bone defects can be successfully addressed with a bone grafting procedure, in situations where a more substantial correction is involved, multiple grafting procedures may be involved. Sufficient bone development may also require surgically harvested bone graft material from elsewhere in the body. However, with distraction osteogenesis, a significant increase in bone length can be achieved with just a single surgical procedure followed by the gradual distraction of the segments. If and when the distraction appliance needs to be removed, only a second and minor in-office procedure is required.