Distraction osteogenesis is a technique used by Dr. Arroyo and other Baltimore oral and maxillofacial surgeons to expand bone. It involves separating segments of bone very slowly, which allows new bone tissue to develop to close the gap between them. The result is a gradual expansion of bone length or width, with the goal of correcting specific oral or facial skeletal defects.
Distraction osteogenesis has been used to treat oral and facial defects since the 1990s. While it was once reserved just for the most severe cases, with advancements in technology and techniques over the past 20 years, distraction osteogenesis has become a much more widely used and predictable method of treatment.
Typically during distraction osteogenesis, Dr. Arroyo will make an incision in the bone to be treated to separate it into segments. Then, a distraction device is inserted – inside the mouth in most cases – which is then adjusted gradually over a period of days or weeks, slowly widening the gap between the segments to promote the growth of new bone tissue. Once the desired bone proportions or position has been achieved, adjustment is discontinued, the bone is fixed in place and the new bone tissue is allowed to heal to become new bone. A second minor procedure will then be performed to remove the distraction device.
Distraction osteogenesis can be used to correct congenital jaw deformities in babies that can obstruct airways or those that impair speech and oral function in older children. It is used in the correction of skeletal facial deformities, such as cleft palate, for instance, or to add length or width to jaws to correct significant jaw deformities. In many cases, patients with such conditions can be helped much more effectively with distraction osteogenesis than with conventional orthognathic or jaw surgeries, gaining a greater degree of correction, less complex and more comfortable treatment, and a substantial reduction of time spent in surgery or the hospital.
Additionally, in recent years, distraction osteogenesis techniques and devices have been developed that aid in developing bone for dental implant placement. This involves cutting a small section of bone, then using a distraction device to promote increased bone height and/or width. After a healing period, the new bone created by the procedure can support dental implants, eliminating the need for bone grafting.
Distraction osteogenesis is, in most cases, a minimally invasive procedure that is performed on an outpatient basis. Patients can expect some pain and swelling after their procedures. Most patients experience some mild discomfort when distraction devices are activated and adjusted, and frequent office visits are necessary throughout the process to keep track of progress and monitor for infection and other complications. Once the process is complete, a second minor procedure is generally necessary to remove the distraction device.