Distraction osteogenesis can be roughly described as bone lengthening. This technique, used in the field of orthopedics, is commonly known as limb lengthening in public. Since 1992, this technique has also been applied to facial bones. By placing a device called a distractor on the jawbones, it is possible to lengthen the bones by 1 mm per day.
Both the lower jaw (mandible) and upper jaw (maxilla) can be easily lengthened among the facial bones. The indication for jaw lengthening surgeries can be summarized as developmental insufficiency of the jawbones.
Congenital and traumatic factors contribute to developmental insufficiency of the jawbones. Among congenital factors, mandibular hypoplasia, Goldenhar syndrome (oculo-auriculo-vertebral dysplasia), Pierre-Robin syndrome, Nager syndrome (acrofacial dysostosis), and Treacher-Collins syndrome (mandibulofacial dysostosis) can be mentioned. Traumatic injuries to the jaw joint (condyle) occurring before the completion of lower jaw development in childhood, when left untreated or not properly managed, can result in shortening of the jawbone in the affected area.
Cases with jawbone shortening can be treated with orthognathic surgery in adulthood (after 18 years of age). However, to address the issue of shortening at younger ages, jaw lengthening surgeries need to be performed. In my own case group, the age of patients ranges from 2 to 21 years.
Cases with jawbone shortening require a thorough examination as a first step. Following the examination, direct radiographs, panoramic mandibular X-rays, and three-dimensional computed tomography scans need to be evaluated. Collaborating with orthodontists is beneficial to achieve excellent results in these surgeries. After a detailed examination and review of the films, the type and nature of the surgery are determined.
Jaw lengthening surgeries should be performed under general anesthesia in a fully equipped hospital. These surgeries can be performed intraorally or extraorally. In both methods, a device called a distractor is placed on the jawbone. The duration of the surgery ranges from 1 to 3 hours, depending on the surgical indication. The lengthening process is initiated 5-7 days after the surgery, and 1 mm of lengthening is done per day. After the lengthening process is completed, the device is kept in place for 6 weeks.
Subsequently, after observing bone formation through jaw X-rays, the devices are removed, and the procedure is concluded. To achieve excellent results in these surgeries, orthodontic treatment should be performed before and after the surgery by orthodontists.
After the surgery, it is essential for patients to protect themselves from consuming hard foods and potential trauma in the area. Careful and meticulous dressing of the externally placed devices is necessary.