The new Alveolar Distractor is an internal distraction device intended for vertical bone augmentation of the alveolar ridge in the mandible and the maxilla with a deficit of in bony height and soft-tissue coverage.
The alveolar ridge deficiency can be a result of:
- Traumatic tooth and bone loss
- Resorption after dental extraction
- Periodontal disease
- Tumor resection
- Congenital deformity
The distraction device consists of:
- The lower body with angulation mechanism which is welded to the base plate
- The upper body with distraction mechanism consisting of a threaded rod as well as a threaded transport plate.
One of the main features of the Alveolar Distractor is its vector adjustability: an angulation mechanism allows easy intraoperative selection of the distraction vector. Therefore, extensive adaptations to the foot plates can be avoided. The distractor can be angled up to 52 toward the buccal and 32 toward the lingual side. After adjusting the vector, the angulation mechanism must be relocked by tightening the fixation screw.
The rigid base plate, with optional screw holes next to the angulation mechanism, allows safe anchorage of the distraction device in the residual bone segment. This leads to high stability ensuring rigidity and preventing potential unfavorable distraction vector changes due to soft-tissue pull.
Three different implant sizes allow for 8 mm, 12 mm, and 16 mm of distraction. This choice offers the flexibility to fit the distractor to different anatomical conditions. To achieve the desired distraction result, the two bodies are connected with a pin to change the plane angle of the bone plates in one dimension. The angulation mechanism allows for fixation of this angle. This feature allows for a single, individual intraoperative adjustment of the distraction vector and addresses the importance of a correct distraction vector in a sagittal plane.
The plate is extended vertically to improve the vertical stability of the system helping to withstand lingual and palatal soft-tissue tension and therefore also guarantees a stable distraction vector. This device has housing for the distraction body to prevent soft-tissue irritation as there is no exposure of the surrounding soft tissue to the threaded rod during distraction and latency.
Distraction should begin 35 days after implantation. To achieve lengthening the activation instrument is turned clockwise (in the direction of the arrow marked on the instrument). Each full rotation equals 0.35 mm of distraction. A rate of 1.05 mm of distraction per day (one turn, three times a day) is recommended to prevent premature consolidation. After a satisfactory gain in alveolar height, the new bone must be given a consolidation period of at least 1012 weeks before the distractor can be removed through the same vestibular incisions used during implantation.
Distraction of a fibula flap in the mandibular body after tumor resection. The additional pin provides stabilization.
Maxillary distraction in a 34-year-old male after periodontal disease.
Mandibular distraction in a 20-year-old male after trauma. The bone biopsy shows a darker shading where the bone is newly formed.
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