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Copyright 1999
Atlanta Oral & Facial Surgery
Seminar in Distraction Osteogenesis for the Maxillofacial Skeleton
Distraction osteogenesis (DO) is a relatively new and exciting surgical treatment for patients with select maxillofacial deformities. Since its introduction by Dr. Gavrielle Illizarov of Russia in the 1950’s, DO has gained acceptance in the orthopedic and other medical specialties as the treatment of choice for select deformities.
On May 6 through 8, 2000, the surgeons of Atlanta Oral & Facial Surgery, in conjunction with Stryker Leibinger, sponsored a seminar in distraction osteogenesis for the maxillofacial skeleton. The faculty of the seminar included Dr. César Guerrero of Caracas, Venezuela; Dr. William Bell of Dallas, Texas, Dr. Harry Legan of Vanderbilt University, Mr. Andy Christiansen of the Medical Modeling Corp., and Dr. Mac Whitesides of Atlanta Oral & Facial Surgery.
On May 6th lecture topics included history of distraction osteogenesis, distraction osteogenesis treatment of the patient with maxillary and/or mandibular deficiency and/or constriction. Distraction osteogenesis treatment of the patient with alveolar ridge atrophy, orthodontic treatment planning of the distraction patient, the effect of distraction osteogenesis on the temporomandibular joint, and anesthesia for the distraction osteogenesis surgery.
On May 7th four surgical cases were performed in the Atlanta Oral & Facial Surgery Outpatient Surgery Center. One case involved employing distraction osteogenesis to expand the maxilla and mandible. In the remaining three cases, DO was used to increase the alveolar ridge height and width in preparation for placement of dental implants.
On May 8th two surgical distraction cases were performed at Emory Cartersville Medical Center. The first case involved using distraction osteogenesis to regenerate a section of the patient’s mandible, which had been resected secondary to a tumor. In the last patient DO was used to lengthen the patient’s mandible in conjunction with tradition orthognathic surgical procedures reduce her vertical maxillary excess.
Frequently Asked Questions About Distraction Osteogenesis
- What does the term distraction osteogenesis mean? Simply stated, distraction osteogenesis means the slow movement apart (distraction) of two bony segments in a manner such that new bone is allowed to fill in the gap created by the separating bony segments.
- Is the surgery for distraction osteogenesis more involved than "traditional surgery" for a similar procedure? No. Distraction osteogenesis surgery is usually done on an outpatient basis with most of the patients going home the same day of surgery. The surgical procedure itself is less invasive so there is usually less pain and swelling.
- Will my insurance company cover the cost of osteogenesis surgical procedure? Most insurance companies will cover the cost of the osteogenesis surgical procedure provided that there is adequate and accurate documentation of the patient’s condition. Of course, individual benefits within the insurance company policy vary. After you are seen for your consultation at our office, we will assist you in determining whether or not your insurance company will cover a particular surgical procedure.
- Is distraction osteogenesis painful? Since all distraction osteogenesis surgical procedures are done while the patient is under general anesthesia, pain during the surgical procedure is not an issue. Postoperatively, you will be supplied with appropriate analgesics (pain killers) to keep you comfortable, and antibiotics to fight off infection.
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.
- What are the benefits of distraction osteogenesis versus traditional surgery for a similar condition? 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.
- What are the 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.
- Can distraction osteogenesis be used instead of bone grafts to add bone to my jaws? Yes. Recent advances in technology have provided the oral and maxillofacial surgeon with an easy to place and use distraction device that can be used to slowly grow bone in selected areas of bone loss which has occurred in the upper and lower jaws. The newly formed bone can then serve as an excellent foundation for dental implants.
- Does distraction osteogenesis leave scars on the face? No. The entire surgery is done within the mouth and the distraction devices used by Dr. Whitesides remain inside the mouth. There are no facial surgical incisions are made so no unsightly facial scars result.
- Are there any age limitations for patients who can receive osteogenesis? No. 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 slightly longer period of distraction and consolidation because the bone regenerative capabilities are slightly slower than those of adolescence or infants.
- For any questions regarding DO please email Dr. Whitesides at: doctormac@mindspring.com
- For Case study reports Please Click here.
- Atlanta Oral & Facial Surgery Seminar in Distraction Osteogenesis for Maxillofacial Skeleton, Click here.