The University of Iowa
The University of Iowa News Services Home News Releases UI in the News Subscribe to UI News Contact Us


8798 John Pappajohn Pavilion
Iowa City IA 52242
(319) 384-9171

Release: July 16, 1999

Rare bone-lengthening procedure completed by UI Health Care oral surgeon

IOWA CITY, Iowa -- Imagine not being able to chew your food, not because you just had a crown put on a molar, but because your upper and lower jaws are so out of alignment that they don't even touch.

After 21 years of struggling to eat and dealing with facial deformities, Andrew Radue is hoping all of that will change. Richard Burton, D.D.S., UI assistant professor of hospital dentistry and a UI Health Care oral surgeon, may be making that dream a reality. On July 8 Burton performed a rare orthognathic surgery on Radue to begin a process called distraction osteogenesis. The theory is simple -- lengthen one jaw to match the other. The application, however, is not so straightforward.

The concept of lengthening bones is not new. During the last 90 years, orthopaedic surgeons have described a variety of procedures. A twist was introduced in the 1950s by Russian orthopaedist G.A. Ilizarov, who suggested new bone could be generated by stretching the existing bone. This process is now called distraction osteogenesis.

Until recently, distraction osteogenesis has mainly been applied to lengthening limbs and fingers and to reconstructing bone defects resulting from tumors. These types of bones are primarily tubular or hollow while most facial bone is made up of thin, membranous bone of a complex structure, creating a unique set of challenges for oral surgeons.

Because the upper jawbone is intricately related to other delicate facial structures, it is extremely difficult to create and control the forces necessary to achieve the desired result. James J. Wheeler, D.D.S., UI assistant professor of hospital dentistry, provided a specially designed appliance which allows transmission of forces from an external pin through an appliance on the teeth to provide the desired movement.

Another problem concerns whether the gaps produced by the distraction process can be filled and healed by newly formed bone. Membranous bone may take substantially longer to grow than the hollow bones found in limbs.

Radue is willing to take the risk.

During the next three to four weeks, Burton believes that the device will be able to extend Radue's upper jaw by 17 millimeters.

Daniel Lew, D.D.S., UI professor and chair of hospital dentistry, also has performed extraction osteogenesis. "My patient required surgery on the mandible (lower jaw) rather than the maxilla (upper jaw). Because of the softer bone structure of the maxilla, it's really an entirely different process," he said. "We're quite fortunate, really, to have Dr. Burton as part of our team."

"This is the first time in Iowa anyone has performed this surgery on the maxilla but the prognosis is good," Burton said. "If all goes well, Andrew will have a lot to smile about in a few weeks."