Distraction osteogenesis or DO is also identified using other terms like osteodistraction, callus distraction, and allostasis. Distraction osteogenesis is the procedure used in podiatric, orthopedic, oral and maxillofacial surgery to rectify deformities in the skeletal through constructive surgery. At the Oral Surgeons of Beverly Hills, the procedure entails the careful separation and cutting of the bone then allowing the gap to be filled through the bone healing process.
When is distraction osteogenesis used?
Distraction osteogenesis is commonly used in podiatric, orthopedic, oral and maxillofacial surgery in rectifying skeletal deformities through reconstructive surgery.
Initially, the procedure was used in the treatment of conditions such as legs with unequal lengths, but since the late nineteenth century, it has been used majorly in the treatment of conditions such as craniosynostosis, micrognathism, craniofrontonasal dysplasias, glossoptosis which causes the airway in babies to be obstructed and hemifacial microsomia.
At the Oral Surgeons of Beverly Hills, we are aware of the research depicting how to DO procedures could be used on the lower jaw, and soft tissues were published in 2016, but the research was of inferior quality and extremely heterogeneous to prove useful.
In the first stage of the procedure which is referred to as the surgical or osteotomy phase the bone is entirely or partially cut through the hard exterior, and the device which will use during the next stage is inserted. During the second phase which is referred to as the latency period, the initial healing processes of the bone are allowed, but the inserted device is not activated. This phase lasts for about seven days. The third phase commonly known as the distraction phase the device inserted on either side of the cut during the first phase is activated and used to separate the two pieces slowly while allowing the new bone to occupy the left gap.
This period lasts for about three days to a whole week. When the maximum length or that which is desired is reached, the consolidation phase comes in where the bone is kept stable by the use of the device until it heals completely. The device supporting the bone will be removed after the consolidation phase is complete and the second surgical procedure follows. Operation of the device is done manually by twisting the rod using the pinion and rack system to separate the bone.
The process of separation is to be carefully executed since abruptly doing it could result in the formation of non-union whereby instead of a bone forming unstable connective tissues that are fibrous are formed. When the process is done very slowly again, it can result in the union occurring prematurely. The separation should be done about a millimeter every day using two steps. Some devices have springs that facilitate the tension needed to separate the bones continuously rather than being operated manually in set intervals.
Risks of the procedure
There is always a chance of an infection after every surgical procedure, there is a possibility that the bone will not grow in the intended direction, the hardware might fail, the pain in the distraction might be very extreme, facial nerve injury, individuals might not be able to accurately follow the distraction protocol and the inferior alveolar might become damaged.