Erste Ergebnisse bei der vertikalen Distraktionsosteogenese des atrophischen Alveolarkamms

Abstract

Besides several conventional therapeutic regimens to treat severe forms of alveolar ridge atrophy the distraction osteogenesis is an alternative method. We introduced a new technique for the treatment of alveolar ridge atrophy encouraged by the advantages of distraction osteogenesis in the last decade. A new technique called "vertical distraction osteogenesis (VDO)" has been developed by our study group to move dentolous and edentolous segments of the alveolar process vertically with a device in microplate-design. Vertical distraction osteogenesis was completed successfully in nine patients with segments length ranging from 6.5 mm to 43 mm with an average of 23.7 mm. The vertical distraction rate was 9.9 mm on average in seven mandibular and two maxillar segments. In all cases we found good stability and the predicted movement of the segments. In contrast to bone transplantation an earlier mineralization in the vertically distracted area could be seen by radiological examination and biopsy. Five patients were treated with dental implants 12 weeks after distraction procedure. Main advantages of vertical distraction osteogenesis are: 1. No bone harvesting, 2. decreased resorption tendency, 3. lower morbidity compared with conventional techniques, 4. lower infection rate and 5. feasibility to insert dental implants 12 weeks after distraction procedure, 6. gain of soft tissue.

Vertical Periodontal Ligament Distraction – a New Method for Aligning Ankylosed and Displaced Canines

“…It is possible that the canine moved back somewhat during those procedures, which would mean that the distraction time was longer than that calculated in the prognosis. Whether V-PDL distraction is also feasible with a distraction path of as much as 1 mm a day, as is realizable for bone [14][15][16] and horizontal PDL distraction [18,20,24,26], should be evaluated in future clinical studies.…”

“…Via osteotomy, a bone segment around the ankylosed tooth is prepared which is mobilized after a latency period of 5-7 days by means of distraction. It is imperative that a uniform speed of movement of roughly 0.5 mm to 1.0 mm per day be maintained so as to induce hard and soft tissue regeneration [14,15]. Both bone-and toothborne distractors are used.…”

“…Both bone-and toothborne distractors are used. Bone-borne distractors represent a greater risk of infection as well as the likelihood of injury to adjacent roots [14]. The tooth-borne designs are less invasive in nature, but they can bring about the unwanted side effect of a reactive intrusion of the adjacent teeth [1,21,28].…”

“…Mit Hilfe der Osteotomie wird um den ankylosierten Zahn herum ein Knochensegment präpariert, das nach Ablauf einer Latenzzeit von 5-7 Tagen mit Hilfe eines Distraktors mobilisiert wird. Von entscheidender Bedeutung für die Induktion der Knochen-und Weichgewebeneubildung ist die Aufrechterhaltung einer gleich bleibenden Bewegungsgeschwindigkeit von etwa 0,5 mm bis zu 1,0 mm pro Tag [14,15]. Es werden sowohl knochengetragene als auch dental verankerte Distraktoren verwendet.…”

“…Es werden sowohl knochengetragene als auch dental verankerte Distraktoren verwendet. Bei den knochengetragenen Distraktoren besteht ein höheres Infektionsrisiko sowie die Gefahr, benachbarte Wurzeln zu verletzen [14]. Die dental getragenen Konstruktionen zeichnen sich zwar durch eine geringere Invasivität aus, als unerwünschte Nebenwirkung kann jedoch eine reaktive Intrusion der Nachbarzähne auftreten [1,21,28].…”