Vertical distraction is a preprosthetic procedure. The distractor lengthens the atrophic jaw (i.e. the previously osteotomized bone segment) by 1 millimeter a day in the planned direction (distraction vector).
Alveolar ridge distraction leads to bone formation in the mandible or maxilla. This represents an important preparatory measure for subsequent prosthetic treatment in cases of early tooth loss or traumatization. As esthetic and functional benefits (tooth implants can be more securely anchored) go hand in hand, the bone growth achieved represents an improvement in any case.
Successful distraction greatly depends on patient compliance. Oral hygiene is essential, smoking strictly prohibited. Besides, we recommend adhering to a soft diet during the entire distraction phase.
The first version developed has been designed for the mandibular body. A second version is available for the ascending ramus. The distractor can be implanted with the plates either downside or upside. Besides, the distractors are completely symmetrical, so there is no right or left version.
The Zurich family of distractors has been specially designed for the treatment of facial hypoplasia/asymmetries in children and adolescents. It allows the safe and almost imperceptible treatment of congenital or acquired malformations.
Flowing bone movements are still possible even after the distractor has been fixed in place because the selected vector can be adjusted or changed anytime. A new bridging rod minimizes the distractor during the consolidation phase.
We utilize this cavity for the fixation of an internal distractor. The Transsinusoidal Midface Distractor (TSMD) allows internal distractions of up to 30 millimeters. Thanks to rigid micro-plates and the distractor’s central midface location, the TSMD can withstand even strong tensile movements. This is a particularly important factor when treating adults. Thanks to the cardanic activation spindle, the patient can optionally activate the system intraorally so that the distractor remains completely invisible. This results in another significant advantage: active distraction can be flexibly accompanied by extended consolidation phases. This prevents recidivations (retrusions) almost completely.
The Arnaud-Marchac distractors take the complexity of craniofacial malformations – especially in children – well into account. The systems have been developed by Eric Arnaud and Daniel Marchac, two leading French surgeons.
In this procedure, the surgeon uses four internal distractors altogether, two of which define neurocranial growth while the other two are responsible for facial-skull growth. Each distractor’s vector can be defined separately and distractor activation can take place separately as well. The low diameter of these distractors ensures maximum patient comfort. At the same time, injury hazards are significantly reduced as falls do no longer pose a risk. Finally, the low size of these distractors allows an extended retention phase, particularly as the distractors do not impede the patient’s daily activities.
Not so if our horizontal alveolar distractor is employed: This tool utilizes the important advantages of distraction to widen the alveolar ridge. The associated soft tissue is simultaneously expanded as well – an important advantage for the prosthetic treatment that is to follow later on.
Thus, the curved path of the newly formed bone will largely reflect the form of the reconstruction plate.
As a rule, distraction takes place from anterior towards posterior. Several joints in the Herford Transport Distractor ensure maximum flexibility (freedom of motion), thus allowing distraction from the symphyseal region well into the mandibular angle region.
Herford distractors are available in a right and left version for distraction lengths of 30 to 60 millimeters. They are based on the entire range of 2.7-mm Thread Lock plates.
KLS Martin has developed its Rotterdam palatal distractor as an alternative to the techniques and implants already in use. It is based on the “lifting jack” principle and – thanks to its extremely low mounting width – suitable even for syndrome patients with narrowings (or distraction requirements) of up to 10 millimeters.
This distractor is the only bone-borne concept requiring no screws for fixing the distractor to the palate – thanks to the sharp-edged pins that wedge into the cortical bone substance, thus guaranteeing secure hold. Just as the implantation, distractor removal is easy as well, leaving practically no scars. And as the Rotterdam distractor has no loose components, there is no danger of small parts being swallowed by the patient.
