What is a Distraction Osteogenesis of the Jaw Ridge (DO)?

Distraction osteogenesis of the jaw ridge is a surgical jaw ridge height restoration using slow traction of two jaw bone segments in opposite directions. Jaw ridge segment is separated from the jaw and slowly lifted upwards using a special distraction device. A new bone tissue is produced this way. Eventually newly formed bone tissue ossifies and patient jaw ridge acquires suitable height for implant placement.

Russian surgeon Dr. G. Ilizarov was the first one to discover this method. Already in the 1950’s he noticed that a new bone tissue can be formed between fractured fragments of long bone of the leg if the fragments were moved in opposite directions by use of a special device. This technique was introduced in jawbone surgery only 10 years ago. It is unique for restoring jaw ridge volume without using bone from any other donor parts – jaw is “cheated” and bone heals naturally complying with all biological principals.

When Does Jaw Ridge DO Need to be Performed?

Jaw ridge is the part of a jaw which used to support teeth before they fell out for some reason. Jaw ridge can atrophy horizontally and vertically for many reasons. Onlay bone grafting restores horizontally affected jaw ridge, slow bone traction method – distraction osteogenesis – is used in a case of vertical jaw atrophy.

What are The Most Common Reasons for Low Jaw Ridge?

Jaw ridge can atrophy vertically (become lower) for various reasons. First of all, tooth loses its physiologic workload and alveolus starts deteriorating after tooth loss. Bone will weaken slightly after tooth extraction if alveolus was healthy. Unfortunately, bone next to unhealthy teeth is usually damaged by periodontal disease and this speeds up bone atrophy after extraction of teeth. Second cause of jaw ridge atrophy is removable dentures. Patient using removable dentures for more than 5 years is under significant risk for jaw ridge atrophy.

When Is The Time for Implant Placement in Augmented Jaw?

Patients have to wait at least 4 months after the bone has been stretched. During this time the bone strengthens and may be used for implant anchorage.

Is Distraction Osteogenesis a Reliable Surgery?

This precise method has been used in jaw surgery for the last 10 years. The data available so far is “euphoric” and lacks strategic and scientifically approved tests. Various cases arise during clinical practice when DO cannot be substituted by any other rational treatment. Our moderate experience confirms that jaw ridge DO is reliable and safe.
Jaw ridge DO causes the least amount of side effects. However, it requires more postoperative care than any other procedure described here.

Does it Hurt during and after the Operation?

Patient feels no pain during operation because the procedure is performed under local anaesthesia or intravenous sedation. Some discomfort will be experienced straight after the procedure as anaesthetic agent effect fades away. Generally pain is mild and easily controlled using non-steroid anti-inflammatory drugs (NSAId). Discomfort usually disappears within a few days, rarely lasts approximately one week.

Are There Any Age Limitations for Patients Who Can Receive DO?

There is no age limit for patients who can undergo DO. Contraindications to this type of surgery are bone metabolism disorders, alterations of immune system and other diseases which have negative influence upon bone healing.

What Is an Alternative to Jaw Ridge DO Operation?

Jaw ridge augmentation using artificial bone or natural harvested one could be an alternative to jaw ridge DO. Although only patients with a small jaw ridge vertical defect can receive bone augmentation surgery. An onlay block grafting is rarely used to restore vertical defects.

When Can I return to work after this surgery?

Facial swelling will be noticeable approximately for a week, so a patient can return to work after approximately one week. It is essential to remember that special distraction device will be activated during second week.

Patient will have to visit our clinic every day if doctor performs the activation process himself. This might hinder patient normal work routine so it would be best to plan a 2 week sickness leave.

What do I Need to Know After Jaw Ridge DO Surgery?

Patient should abstain from smoking at least a few days after the operation, physical activities should be limited. It is advisable to avoid chewing on the operated side for up to 3 or 4 weeks.

Also, we urge you to restrain from leaving the country for at least 2 weeks. Please read more in our booklet “What you should know after jaw ridge DO surgery” that you can pick up at the clinic.