Re: oral distraction, is it the future? My thoughts

[Guest guest]

Interesting topic.

I considered vvery seriously distraction back in 2002. From what I

read and talked to doctors about, there is less possibility of

numbness since the jaw is moved " slowly " and not in one shot. The

expansion is not that painful, definitely not pleasant, but what is

in this area? Within a week, one can distract 7 mm or more. The

important thing is that the soft tissue moves with the bone and

everything is local to the distraction so less injury and trauma to

the nerves etc.

Now it has to be done right. Very few people specialize, Razdolsky

and Dessner in Chicago (oraldistraction.com) and Dr. CHin in San

Fracisco (http://www.distraction.net/) are top. I live closer to the

latter so I visted him and consulted for a few times but my case took

the wrong turn (my ortho didnt coordinate probably) so I never did

anything in those lines. I also called the CHicago doctors who

invented a series of distractors to be used.

My opnion is that this procedure should be used primarily in two

cases. First, when more than 1 cm of advancement is needed. Actually

if that is the case, there is not even argument, most doctors will do

that for sure to avoid huge gaps and risk of nonunion of bone etc.

Second, it can be done when there is need for " intraoral " space and

one does not want tooth extractions. Ditracting can be done at any

point so it is the only procedure that actually creates bone

intraorally for fitting all teeth without asking patients to extract

wisdoms and bicuspids etc to make space.

The non-extraction option was my main motivation to cosider the

procedure. I didnt want to hear about losing a bunch of healthy teeth

to " make space " for the orthos. However, at the end I did some

expansion with appliacnes to avoid the surgery and moved on. Now my

result might end up with relapse since no new bone was created; I was

just forced to fit all the teeth in wider arch. I need retainers for

ever I guess to keep them for moving around inside again.

The main risk of distraction is that the cuts are intraorally so they

approach the roots of the teeth and with inexperienced doctors it

might be issue. So since it is newer technique, I would only do it

with top specialist doctors and not with anyone.

Bottom line, if less than 8-10 mm movement is needed, go the regular

surgeries are fine. For more movement, distraction is really the only

option. Also, if not losing teeth is a big issue for some people,

then distarcton might again be the better way to create intraoral

bone to fit all teeth without extractions.

> >

> > Although my jaw surgery was ten years ago and I recently

> > " upgraded " by having a second genioplasty to obtain full profile

> > correction, I find the oral distraction technique to be quite

> > interesting. A fellow patient on this board recommended I check

> > it out as a possibility for my chin issues, and although they do

> > not appear to to distraction for chin advancement, I found the

> > distraction website to be very interesting. There was a recent

> > post from a distraction patient and if you read this, I'd like to

> add

> > a couple questions. You mentioned that the daily advancements

> > of the screw mechanism were quite painful. Is a distraction unit

> > placed on both sides of your jaw? and was yours for lower

> > advancement or upper? I'm curious too about eating, talking,

> > etc. Apparently there isn't the same degree of restriction as in

> > conventional jaw surgery, but those distractors look quite

> > intimidating. It certainly looks like this is a very viable

> alternative,

> > and may be particularly helpful in cases that would otherwise

> > require bone grafts. It seems from my studies of historical

> > developments of medical techniques that if a certain protocol

> > enables patients to obtain superior results with overall less

> > downtime and suffering it eventually becomes a mainstream

> > practice. And just for interesting sideline info: Would you

> believe

> > the first mandibular advancement was done in the 1840's, and

> > early maxillary procedures only partially mobilized the maxillary

> > area and relied on external traction (who knows what that

> > consisted of) to finish the movement.

[Guest guest]

Interesting topic.

I considered vvery seriously distraction back in 2002. From what I

read and talked to doctors about, there is less possibility of

numbness since the jaw is moved " slowly " and not in one shot. The

expansion is not that painful, definitely not pleasant, but what is

in this area? Within a week, one can distract 7 mm or more. The

important thing is that the soft tissue moves with the bone and

everything is local to the distraction so less injury and trauma to

the nerves etc.

Now it has to be done right. Very few people specialize, Razdolsky

and Dessner in Chicago (oraldistraction.com) and Dr. CHin in San

Fracisco (http://www.distraction.net/) are top. I live closer to the

latter so I visted him and consulted for a few times but my case took

the wrong turn (my ortho didnt coordinate probably) so I never did

anything in those lines. I also called the CHicago doctors who

invented a series of distractors to be used.

My opnion is that this procedure should be used primarily in two

cases. First, when more than 1 cm of advancement is needed. Actually

if that is the case, there is not even argument, most doctors will do

that for sure to avoid huge gaps and risk of nonunion of bone etc.

Second, it can be done when there is need for " intraoral " space and

one does not want tooth extractions. Ditracting can be done at any

point so it is the only procedure that actually creates bone

intraorally for fitting all teeth without asking patients to extract

wisdoms and bicuspids etc to make space.

The non-extraction option was my main motivation to cosider the

procedure. I didnt want to hear about losing a bunch of healthy teeth

to " make space " for the orthos. However, at the end I did some

expansion with appliacnes to avoid the surgery and moved on. Now my

result might end up with relapse since no new bone was created; I was

just forced to fit all the teeth in wider arch. I need retainers for

ever I guess to keep them for moving around inside again.

The main risk of distraction is that the cuts are intraorally so they

approach the roots of the teeth and with inexperienced doctors it

might be issue. So since it is newer technique, I would only do it

with top specialist doctors and not with anyone.

Bottom line, if less than 8-10 mm movement is needed, go the regular

surgeries are fine. For more movement, distraction is really the only

option. Also, if not losing teeth is a big issue for some people,

then distarcton might again be the better way to create intraoral

bone to fit all teeth without extractions.

> >

> > Although my jaw surgery was ten years ago and I recently

> > " upgraded " by having a second genioplasty to obtain full profile

> > correction, I find the oral distraction technique to be quite

> > interesting. A fellow patient on this board recommended I check

> > it out as a possibility for my chin issues, and although they do

> > not appear to to distraction for chin advancement, I found the

> > distraction website to be very interesting. There was a recent

> > post from a distraction patient and if you read this, I'd like to

> add

> > a couple questions. You mentioned that the daily advancements

> > of the screw mechanism were quite painful. Is a distraction unit

> > placed on both sides of your jaw? and was yours for lower

> > advancement or upper? I'm curious too about eating, talking,

> > etc. Apparently there isn't the same degree of restriction as in

> > conventional jaw surgery, but those distractors look quite

> > intimidating. It certainly looks like this is a very viable

> alternative,

> > and may be particularly helpful in cases that would otherwise

> > require bone grafts. It seems from my studies of historical

> > developments of medical techniques that if a certain protocol

> > enables patients to obtain superior results with overall less

> > downtime and suffering it eventually becomes a mainstream

> > practice. And just for interesting sideline info: Would you

> believe

> > the first mandibular advancement was done in the 1840's, and

> > early maxillary procedures only partially mobilized the maxillary

> > area and relied on external traction (who knows what that

> > consisted of) to finish the movement.