Distraction Osteogenesis

A minimally-invasive treatment for patients with facial deformities involving the gradual lengthening of bone using a "distractor".

MassGeneral pioneers

Distraction osteogenesis (DO) for facial expansion was developed principally by oral and maxillofacial surgeons at MassGeneral, and this hospital is still the only hospital in New England where this procedure is performed regularly.  Dr. Edward Seldin patented the first fully implantable distraction device for the face, while Drs. Leonard Kaban and Maria Troulis of the Skeletal Biology Research Center have refined the procedure first on animal models and then for use in patients.  Today distraction osteogenesis is an elegant solution that makes use of a generation of technological advances, including three-dimensional surgical planning software developed in conjunction with the Harvard Surgical Planning Laboratory.

Benefits of DO

Since a large number of patients requiring mandibular reconstruction are children, there is a great incentive to develop approaches and techniques that achieve excellent outcomes but limit the number or severity of surgical procedures required.  Around eighty-five percent of pediatric mandibular reconstruction patients require skeletal expansion, traditionally achieved by bone grafts or soft-tissue flaps harvested from the patient's hip, skull, or ribs.  The goal of DO is to correct or repair facial deformities while avoiding donor-site harvesting.

There are additional benefits of DO.  The procedure can be performed using minimally invasive techniques, sometimes even endoscopically.  In micrognathic patients, studies show that DO permits the jaw to be moved greater distances than with conventional surgery and that the newly created bone appears to be more stable.

Candidates for DO

During a consult with your oral and maxillofacial surgeon the doctor will discuss your or your child's diagnosis.  Together you will decide on a treatment plan that is best.  Candidates for distraction osteogenesis are normally children with micrognathia, midface hyperplasia (cleft lip/palate, Crouzon or Apert syndrome) and those with acquired conditions resulting from trauma, tumor resection, or radiation therapy.

These procedures represent our doctors' commitment to providing the best patient outcomes by applying state of the art technologies to advancing the treatment of oral and maxillofacial anomalies.