Distraction osteogenesis
Distraction osteogenesis lengthens bone gradually. A small device is fitted to the jaw and adjusted day by day, so new bone and the surrounding soft tissues grow together.
Who it may help
- An underdeveloped lower jaw from craniofacial microsomia or other congenital conditions
- Some babies and children with airway problems from a small lower jaw
- Selected adults where a large movement is needed
Recovery
The lengthening phase takes a few weeks, followed by a consolidation period of around two to three months. Regular review checks progress. A soft diet is needed during treatment.
What is involved
Under general anaesthetic the bone is divided and a distractor fitted, either inside the mouth or through a small skin incision. After a few days the device is turned, usually about a millimetre a day, until the planned length is reached. The bone then strengthens over several weeks before a second, shorter operation removes the device. Will’s research doctorate developed a personalised, fully buried distractor designed from 3D scans.
Risks and side effects
All surgery carries some risk. The main ones for this treatment are listed below; your own risk depends on your health and the details of your operation.
- Infection around the device or pin sites
- Device loosening or breakage
- Nerve injury causing numbness, or damage to developing teeth
- Scarring where the device passes through the skin
- Some relapse, or the need for further surgery as a child grows
Alternatives
Depending on age and diagnosis, alternatives include orthodontic treatment, bone grafting, corrective jaw surgery once growth is complete, or monitoring.
Guidance and standards
Paediatric oral and maxillofacial surgery is one of Will’s subspecialty interests. Children are treated within specialist paediatric networks, with a planned transition to adult care.
Questions worth asking at your appointment
- Benefits – what will this treatment do for me?
- Risks – what could go wrong, and how likely is it for me?
- Alternatives – what other options are there?
- Nothing – what happens if I wait, or decide not to have treatment?
Based on the Choosing Wisely UK BRAN questions.