DISTRACTION OSTEOGENESIS IN THE MAXILLOFACIAL
REGION
Distraction osteogenesis
of the jaw bones is a recent development where short or under-developed bone
may be lengthened without bone grafting.
Technically, it is a process by which bone is
lengthened by progressive stretching. A
surgery is performed to create a controlled “fracture”. The fracture is
allowed to “heal” for a period of 3-7 days. The “healing” bone is then
stretched apart systematically by 1 mm every day until the desired length is
achieved. It is left to
mature for 2-4 months.
The distraction or stretching is achieved by
mechanical devices called “distractors”. For jaw and facial bones, most distractors are “buried” on the bone surface and invisible,
as aesthetics is a major concern.
Distraction osteogenesis
has been employed in
the maxillofacial region for many
conditions where there is shortening or under-development of the bone. Amongst
the conditions are:
·
Craniofacial syndromes such as hemifacial
microsomia, Crouzon, Apert and cleft deformities
·
Dento-facial deformities (orthognathic conditions)
where the lower jaw (mandible) or upper jaw (maxilla) is anatomically small
(hypoplastic)
·
Deformities arising from cancer or tumour
surgeries
·
Atrophied or “flat” jaw bone that is insufficient for dental
implant placement.
As for any surgical technique, there are
advantages and disadvantages.
Advantages:
·
No necessity
for bone grafts to be taken from another part of the skeleton.
This prevents post-operative discomfort and additional surgical risks.
·
The facial soft tissue is also stretched. As a result, the long
term risk of relapse is minimized.
·
Predictable, with minimal infection.
·
Rapid healing. If dental implants are planned, it can be performed
in two months.
Disadvantages:
·
Distractors may uncomfortable or if, external, visible.
·
Inconvenience to patients. Patient may have to attend the surgeon’s
practice every day during the distraction.
·
Second surgery is required
to remove the distractor
·
Added cost of the distractor.
·
Distractors may occasionally fail.
Disclaimer:
The above article is strictly for information
only. It is NOT intended as treatment advice over the Internet. If you need any
assessment, you must see your Oral & Maxillofacial Surgeon.