Distraction Osteogenesis


What is Distraction Osteogenesis?


 Distractor appliance set in jaw as seen on digital x-ray imageYou may be familiar with orthopedic procedures that have been developed to treat children who may have one leg that grows longer than another. These procedures are designed to expand, stretch, or lengthen a bone, and are termed “Distraction Osteogenesis.” Distraction Osteogenesis can be applied to the facial bones, jawbones, or even small segments of the jaws to expand or lengthen them.

How is Distraction Osteogenesis used in the jaws?


You may have heard of an orthodontist placing a palatal expansion appliance in a child to widen and expand their upper arch for space in which to move the teeth. In adults, expansion of this type requires a SARPE procedure (Surgically Assisted Rapid Palatal Expansion.) These types of treatments are examples of Distraction Osteogenesis.

To optimize the amount of bone in an area prior to implant placement, Distraction Osteogenesis may be recommended to expand or lengthen a small area of the jaw that is to be treated with dental implants. Distraction Osteogenesis can even be used to lengthen or expand a portion of the upper or lower jaw, or if needed, the entire jaw.
Distraction Osteogenesis case study Pre-Op Image 1
Distraction Osteogenesis case study Pre-Op Image 1
Distraction Osteogenesis case study Post-Op Image 1
Distraction Osteogenesis case study Post-Op Image 2

How is Distraction Osteogenesis performed on the jaws?


The basic process is to first expose the area to be treated. Small cuts are then made in the dense hard bone on the outside of the jaw (termed “osteotomies.”) A small device (a “distractor”) is attached to both the cut and uncut portions of the bone. Commonly, most of this distractor is buried under the gum tissue. The area is then allowed to heal for one week. At that point, the distractor is activated daily, by you or the doctor, to slowly expand the area as needed. Once fully expanded, the distractor is fixed in place for 3 months to allow for full healing of the bone.

Why use Distraction Osteogenesis instead of bone grafting?


Mold of jawbone showing distractor deviceCloseup  of teeth and jaw prior to distraction osteogenesis procedureIf the amount and direction of the required bone augmentation, the space available, or the movement necessary is beyond what can predictably be attained from conventional bone grafting procedures, then Distraction Osteogenesis techniques may be advised. Remember, Distraction Osteogenesis procedures use the patient’s own living bone for the expansion and augmentation. Sometimes a combination of Distraction Osteogenesis and conventional bone grafting is required. It depends on the individual patient case.

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