Contact:
Dr. Hana Frauenknecht
Phone: +41 (0)41 850 88 83
E-Mail: info@pps.ch
- Salzburg Method
- Endo-Distractor
- teeth
- dentist
- health
| Pressbox | 
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| Prof. Christian Krenkel with Model |
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Salzburg (pts034/04.11.2008/13:45) - Quantum leap in dentistry: Targeted alveolar ridge regrowth with Endo-Distractor KRENKEL® - now also for treating single tooth loss
With the launch of the Endo-Distractor KRENKEL® (see Press release 10/24/2007: Callus distraction system KRENKEL® ready for marketing) maxillofacial surgeons were provided with a tool for controlling major maxillary and mandibular deficiencies on an outpatient basis. Meanwhile extensively tested and well established, the "Salzburg Method" was extended by the development of a miniaturized version of the Endo-Distractor - a must for every implant dentist.
Management of maxillary and mandibular single tooth loss
Single tooth gaps in the upper and lower arch are increasingly seen in both young and elderly individuals. Sports or road traffic accidents and severe local inflammatory disease with resultant bone or tooth loss are among the causes. In most cases the available residual bone is not sufficient for supporting implants. This can now be remedied by dental and oral surgeons or implant dentists: Without general anesthesia a small osteotomy is made after a local anesthetic is injected and a miniaturized Endo-Distractor KRENKEL® is placed for distraction osteogenesis. Supervised by the dentist or surgeon, distraction is controlled by the patient and is completed within 10 to 20 days. After a healing time of another 12 weeks the site is fully regenerated so that the Endo-Distractor can be removed and replaced by a dental implant, which is placed as usual after contouring the bone to obtain a scalloped margin. This provides the patient with esthetic crowns, natural gums and papillae supported by true bone.
Targeted bone regeneration with customized tools: The KRENKEL® Endo-Distractor family
KRENKEL® Endo-Distractors are made of titanium and manufactured with high-precision techniques. They come in three ready-for-use versions for universal customized bone regeneration.
Standard Endo-Distractor
This version is intended for regenerating maxillary and mandibular bone with severe deficiencies or loss of several teeth. It produced excellent results in more than 100 cases. With careful planning a bone gain of up to 15 mm is achieved with it by targeted callus formation to the level of the laterally adjacent alveolar crest. No more than one year after its launch the Standard Endo-Distractor has become a valuable tool for reconstructive, orthognathic and cosmetic/plastic surgeons.
Mini Endo-Distractor
This miniaturized version was designed for remedying "minor" problems in the upper and lower arch. Both single-tooth or consecutive two- to three-tooth gaps can be easily regenerated. Fig. 1 shows professor Krenkel with a mandibular model harboring two Mini Endo-Distractors. The distractors are equipped with hollow screws. The size of these hollow screws is determined by the level of the (upper arch) antagonist. As a result, callus formation can be extended beyond the actually needed level so that the bone can be contoured to a scalloped near-normal shape. This ensures a firm permanent support for the papillae.
During the distraction and healing time patients are provided with temporary dentures and resume their normal lives unimpaired.
For planning the placement of the slender-bodied Mini Endo-Distractor - its diameter is no more than 1.5 mm - the usual drill guides can be used. In complex cases three-dimensional radiographic reconstructions combined with computer simulations are resorted to - such as are becoming increasingly common in implant dentistry. This technique is also ideally suited for planning and preparing distractions. It ensures that the desired bone gain is achieved reliably and with high precision and guarantees an optimal esthetic outcome. The first series of the Mini Endo-Distractor is currently being tested clinically.
Midi and Midi-Plate Endo-Distractor
These versions feature a distraction screw with a diameter of 2.0 mm, are primarily designed for the posterior arch and can be combined with so called locking plates and engaging screws. As they are placed transmucosally, they do not cover the periosteum of the transport segment.
Unlike plate distractors and other designs, the KRENKEL® Endo-Distractor family does not necessitate secondary surgery for metal removal. Optimal callus formation is obtained without lateral fixation. At the end of the distraction time the distraction screws and the guide sleeve of the Midi Plate are simply rotated out of the bone. The extramucosal placement of the 3-D plates obviates any instrumentation of the bone or the mucosa.
Figs. 2 to 5 are simplified illustrations of various applications so far all but barred to dentists. Fig. 5 shows an example of the osteotomy line cut with a piezo-electric saw. The KRENKEL® Mini Endo-Distractor is designed for use in regions 1 to 6, the Standard Endo-Distractor for region 7. Surgery is performed on an outpatient basis throughout. For instrumenting regions 1 to 6 a local anesthetic is sufficient for pain control.
The surgical technique is taught at courses (for schedule see http://www.endodistraction.com) and is subject to continuous development.
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