Jaw Reconstruction (Distraction Osteogenesis)

What is jaw reconstruction?

 

Jaw reconstruction (distraction osteogenesis) is used to repair deformed jaw bones.  It is used to correct

• underdeveloped jaws 
• cleft lips and palates
• a defect where one side of the face grows faster than the other
• other facial growth syndromes
• fractures of the upper or lower jaw where bone loss has occurred

 

It can be applied to both the upper jaw (maxilla) and the lower jaw (mandible)).  It can be used for both adults and children.

 

The Distraction Process

 

It involves slow, controlled spreading of surgically created bone segments to expand soft tissue and bone. 

 

This process requires two surgeries.  The device is placed in the first one.  It is removed during the second one, after the desired bone growth is reached. 

 

Your doctor will place the device across a cut area of bone.  After a period of time (each patient is different), the distractor pins are turned at precise intervals and distances.  These pin turns are done until the desired length of bone is reached.  This is most often done twice a day for 7-14 days.  The pins are turned 1 mm per day.  After the distraction process, a time of healing is needed.  This takes 6 to 8 weeks.  Your doctor will remove the device after the newly formed bone has hardened.

 

What to Expect after Surgery

 

• Time for recovery depends on which jaw the surgery is done.  It also depends on the type of device used.
• You may stay in the intensive care unit (ICU) for one night or more in order to have your breathing pattern watched.
• You will stay in the hospital about 5 days.
• The length of distraction most often lasts between 7-14 days during which time you can resume your normal routines with somewhat less physical activity.
• Throbbing, aching, swelling, bruising, and numbness may occur around the sites.  The swelling should go down within 7-10 days.  The other symptoms should go away.  There is some swelling until the distraction phase of treatment is over.

 

Caring for the Distractors

 

• There may be some drainage from the pin sites for 2-3 days.  Use a Q-Tip® to apply half-strength hydrogen peroxide (hydrogen peroxide mixed with the same amount of water) to the pin sites.  Then, use a Q-Tip®, to apply antibiotic ointment to the pin sites.
• This must be done three times each day.

 

The Distraction Period

 

• Before going home, you will be taught how to turn the screws on the device.  This may be uncomfortable.  It may be helpful for you to take pain pills about 30 minutes before each distraction.
• You will be closely watched during the active phase of distraction with clinic visits every few days.  Once the process is completed, the visits will be every 1 or 2 weeks.
• Eat soft or pureed food during this time.
• You will take antibiotics during and after the surgery to prevent infection.

 

When to Call the Doctor

 

Call your doctor if you have any questions or if

 

• You have drainage from the pin sites, or increased pain, swelling, or redness around the pin sites.
• You have a temperature greater than 101.5° F for two readings taken 4 hours apart.
• You have severe or increasing pain not relieved by medicine and rest.
• You have drooling or it is hard to bite or chew.

 

Phone Numbers

 

Plastic Surgery Clinic, weekdays, 8 am to 5 pm (608) 263-7502.

After hours, weekends and holidays, the clinic number is answered by the paging operator.  Ask for the plastic surgery resident on call.  Leave your name and phone number with the area code.  The doctor will call you back.

 

If you live out of the area, call toll-free 1-800-323-8942.

 

 

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 03/31/2008

Copyright © 03/28/2008 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. UWH #6028

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