Corrective Jaw Surgery/Distraction Osteogenesis

Corrective Jaw Surgery is also known as Orthognathic Surgery. It is used to treat a variety of facial and jaw abnormalities in which the facial bones and teeth are not correctly developed. This results in difficulty with chewing, speech, and jaw function. In many cases, the facial appearance is affected by this problem. Orthognathic means "straight jaws", and orthognathic surgery corrects these jaw and facial deformities, usually in conjunction with an orthodontist, so that after the jaws are corrected, the teeth will come together properly.

Sometimes, braces alone can correct a problem with the bite, but when it is severe, usually orthognathic surgery is required. Abnormal jaw and facial development can be genetic or acquired due to disease or injury. When the jaws are not properly developed or proportioned, problems such as difficulty chewing, jaw and facial pain, speech abnormalities and dental problems can result. Using sophisticated surgical techniques, the facial bones can be repositioned in order to restore proper function and facial appearance.

Jaws are no longer "wired shut", as the repositioned jaws can be held in place with miniature titanium plates and screws which are used to fixate the facial bones in their new relationship. This, in combination with new instruments and anesthetic techniques, has allowed orthognathic surgery to be safer and more effective, and is much easier for the patient to undergo. New advances in orthodontics have also allowed the total treatment times to be shortened.

Orthognathic surgery is performed in the hospital or outpatient surgical center. Patients generally stay in the hospital 1-2 nights, depending on the extent of surgery done. Most patients state that the post-operative discomfort is much less than they were expecting. Almost all patients agree that they are happy with the results and would go through the surgery again, without hesitation. The improvement in jaw function and facial appearance is remarkable. Most patients experience a great improvement in their self-confidence and quality of life after orthognathic surgery.

Distraction Osteogenesis

Distraction osteogenesis (DO) is a relatively new method of treatment for selected deformities and defects of the oral and facial skeleton. It was first used in 1903. In the 1950s, the Russian orthopedic surgeon, Dr. Gabriel Ilizarov slowly perfected the surgical and postoperative management of distraction osteogenesis treatment to correct deformities and repair defects of the arms and legs. His work went mostly unnoticed until he presented to the Western Medical Society in the mid-1960s.

Distraction osteogenesis was initially used to treat defects of the oral and facial region in 1990. Since then, the surgical and technological advances made in the field of distraction osteogenesis have provided the oral and maxillofacial surgeons with a safe and predictable method to treat selected deformities of the oral and facial skeleton.

Our Doctors use distraction osteogenesis to treat selected deformities and defects of the oral and facial skeleton.

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 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 vs. 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 to four 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.

Does distraction osteogenesis leave scars on the face? No. The entire surgery is performed within the mouth and the distraction devices used by our Doctors remain inside the mouth. There are no facial surgical incisions are made so no facial scars result.