Distraction Osteogenesis (DO) is the surgical technique in which new bone formation is stimulated by the gradual separation of bony segments after an osteotomy. Distraction procedures for the facial skeleton are relatively new, being first reported in the English literature in 1992. The surgery involves placement of a device across a surgical site and after a suitable healing period of about one week.  The device is activated at a rate of one millimeter per day. New bone is laid down as the segments are separated and a greater degree of bone lengthening can be gained than by conventional surgery. A healing period of about four months is necessary prior to removal of the distractors. The devices used at Face and Jaw Surgery are placed internally, as opposed to unsightly external appliances. DO is reserved for difficult cases where there is need for large bony movement or where there is no reasonable conventional alternative.

Case 1

Ten-year-old male, diagnosis of hemifacial microsomia, type III. Patient had reconstruction of lower jaw with rib graft at age 5. Internal distractor utilized to correct facial asymmetry.

Before Distraction Osteogenesis by Oral Surgeons in North Dakota Pre-op Frontal Photo
After Distraction Osteogenesis by Oral Surgeons in North Dakota Post-op Frontal Photo
Digital Radiograph before Distraction Osteogenesis by Oral Surgeon in North Dakota Panoramic radiograph showing distractor in place
Digital Radiograph after Distraction Osteogenesis by Oral Surgeon in North Dakota Panoramic radiograph post removal showing well healed bone in area of distraction

Case 2

Seven year old patient with diagnosis of mild Treacher-Collins Syndrome. History of severe snoring and marked mandibular hypoplasia. Stereolithographic models were obtained for treatment planning. Patient had bilateral osteotomies, mandibular lengthening of 15 mm.

Before Distraction Osteogenesis by Oral Surgeons in North Dakota Pre-op Lat
After Distraction Osteogenesis by Oral Surgeons in North Dakota Post-op
Before Distraction Osteogenesis by Oral Surgeon in North Dakota Pre-op model
After Distraction Osteogenesis by Oral Surgeon in North Dakota Post-op model

Case 3

17 year old patient with transverse hypoplasia in max and mand arches. Surgically assisted rapid palatal expansion and mandibular expansion utilizing distraction.

Before Distraction Osteogenesis by Oral Surgeons in North Dakota Pre-op frontal view
After Distraction Osteogenesis by Oral Surgeons in North Dakota Post-op frontal view
Before Distraction Osteogenesis by Oral Surgeon in North Dakota Pre-op Occlusion
After Distraction Osteogenesis by Oral Surgeon in North Dakota Post-op Occlusion
Before Distraction Osteogenesis by Oral Surgeons in North Dakota Pre-op Mand Arch
After Distraction Osteogenesis by Oral Surgeon in North Dakota Post-op Mand Arch
Before Distraction Osteogenesis by Oral Surgeons in North Dakota Pre-op Max Arch
After Distraction Osteogenesis by Oral Surgeon in North Dakota Post-op Max Arch