Distraction Osteogenesis

 

Facial asymmetries arise in most cases due to growth disturbances and manifest themselves in early youth. Through operative displacement of the middle part of the face, the upper jaw and lower jaw, facial harmony and teeth positions can be restored.
 

The face is the most important organ for human beings; it is the most powerful expression of a person's identity. At the Klinik Professor Sailer, we do everything we can to compensate for growth and developmental disorders as perfectly as possible. An aesthetically pleasing result will be the first step in helping the patient overcome his or her suffering.

 
HISTORY

Distraction Osteogenesis was first used in orthopedic medicine in the early 1900's, but the current concepts evolved from the ideas of Dr. Gavriel Ilizarov, who practiced medicine in Kurgan, Siberia. Dr. Ilizarov, who had great understanding of the biophysiolgy of bone, developed techniques to move bone fragments in controlled vectors using a system of wires and fixed rings joined together with threaded rods and hinges. This technique allowed slow transport of bone segments without invasive surgery and was especially practical in the treatment of fractures in children and in lengthening of bones in the legs where there was a discrepancy between right and left bone lengths.
 

DENTAL HISTORY

The transfer of techniques involving D.O. in medicine to those used in dentistry was not an easy task. The reason being that the shape, size, location of bones is much different. The primary boost in the development of distraction osteogenesis techniques in the dental field came from the conceptualization and construction of miniature devices that could move small bone fragments in a controlled vector. In 1992, McCarthy, was the first to publish on the use of distraction osteogenesis to lengthen a human mandible. Dr. Martin Chin, a maxillofacial surgeon in San Francisco, was and still is a primary leader in this process.
 

INDICATIONS

Mandibular Lengthening
  Anterior-posterior deformity
    Trauma reconstruction
   

Cancer reconstruction
Craniofacial syndrome
Redo
Mandibular Widening
Crowding with A-P deformity
Brodie Syndrome
Asymmetry
Craniofacial Syndrome
Maxillary or mandibular alveolar distraction
Insufficient alveolar height and/or width
Previously failed bone graft sites
Insufficient soft tissue coverage
Insufficient dona bone available
Patient is not a candidate for a bone graft

  
       
Disadvantages of distraction osteogenesis
    Little relapse
    Bigger movements possible
    Ability to mold the regenerate
    Out-patient surgery
    No need to extract teeth
    Generation of soft tissue
    Less likelihood of nerve injury
    Less likelihood of idiopathic condylar resorption
    Technique sensitive surgery
    Equipment sensitive surgery
    Possible need of second surgery to remove distraction devices
    Patient compliance