Re: Distraction Osteogenesis

[Guest guest]

Hi!

I have had two distraction osteogenesis procedures done on my jaw.

The first was done to lengthen my lower jaw by 17 mm and the second

to reconstruct the condyles by building up the bone about 15 mm.

Distraction osteogenesis is typically used when larger movements of

bone are required. My surgeon told me he only considers it when more

than 10 mm of new bone is needed.

During the surgery, the surgeon places the distractor across the

bone that is to be lengthened. Then a cut is made through the bone.

As the distractor is turned, the two pieces of bone are pulled apart

and new bone grows in. Typically the screws are turned twice a day

for a total of 1 mm of new bone per day. Distraction can be done on

the upper or lower jaw. Mine were both on the lower.

Here are some websites of the kind of distractors I had.

http://www.klsmartin.com/MOD-line/molina.htm

http://www.klsmartin.com/MOD-line/zurich_mand.htm

http://www.klsmartin.com/MOD-line/zurich_max.htm

One of the advantages to distraction is that bone grafts that are

otherwise needed for such large movements can be avoided. One of the

main reasons that we used distraction to advance my mandible is that

the gradual movement is theoretically less stressful on the soft

tissues and joints. Finally the surgeon can fine-tune the final

position of the jaw and correct for any asymmetries by turning one

side more than the other.

There are also several disadvantages. I found it to be very painful.

Every time we turned the screws, it felt like the first day post-op.

Fortunately my surgeon gave me strong pain meds but needless to say,

I don't remember much of that time. I took the pain meds an hour

before we turned the torture device and I iced my jaw for an hour

before and afterwards to help numb it. The whole process also takes

a lot longer. We had to wait a week after the distractors were

placed and then we turned the screws for almost three weeks

afterwards. I didn't feel like I was even beginning to recover until

four weeks post-op. It was six weeks before I ventured out of the

house by myself and eight before I could return to work. I was on a

liquid/ mushy non-chew diet for at least 10 weeks.

It was more expensive as well. The first surgery was $58,000 and

$15,000 to remove them. The second distraction was a little more

expensive because the distractors had to be custom made. That one

was $86,000. Insurance did cover the surgeries but with a 10 % co-

pay, the cost to us was still substantial.

Finally, it does require a second surgery to remove them but that

was easy. I recovered and was back at work in a week.

The first distraction (to lengthen my lower jaw) was done in

September 2002 and held up very well. That part of my jaw is still

solid and stable. Unfortunately the second distraction to rebuild

the condyles, done in January 2004, was not as successful. I have a

very destructive arthritis in my joints stemming from TMJ problems

since childhood. The new condyles were stable for a little over a

year but now the bone is deteriorating again. In the last two

months, I've lost about 6-7 mm of bone in the joints. Now I'm

scheduled for artificial joint replacement surgery on June 29.

What kind of surgery is your daughter having? How old is she?

Distraction is used more in children. Let me know if you have any

other question. I do have pictures of me with the distractors in

place. Email me at minirascal@... if you're interested in seeing

them.

> Hello,

> I'm new to this site and am hoping someone can help me. My

> daughter's

> Ortho. tells us it is time for her to have jaw surgery. She is

> recomending that she have Distraction Osteopenesis. Does anyone

have

> any experience or know anything about this procedure? I would be

> grateful for any help.

>

> Thanks,

> Lee