Abstract
Edentulous patients require an adequate rehabilitation so that the alveolar ridge in the interforaminal region be restored for subsequent implant-supported overdentures. The ultimate goal of distraction is to reconstruct the alveolar ridge to a suitable height and width compatible with Atwood class 2 in an appropriate direction allowing the sagittal interalveolar relation to be normally restored. Methods. A 65-year-old man presented with a grade 4 Mandibular atrophy as per Atwood classification which resulted in unsatisfactory treatment with full dentures. Endo-Distractor Krenkel® device was used for anterior mandibular vertical distraction osteogenesis. Four mandibular implants (ITI Straumann, Basel, Switzerland) measuring diameter Ø = 4.1 mm and length L = 16 mm were inserted after the required retention period. Standardized prosthetic treatment was completed with titanium bar retained over dentures. Results. A distraction of 11 mm was achieved within 18 days followed by a retention period of 4 months. No signs of infection nor distractor anchorage loosening were detected, and minimal lingual tilting has occurred. Conclusion. Distraction is possible on severely atrophic mandibles. The quality of bone reconstruction is satisfactory for both functional and esthetic results.
Highlights
Resorbed mandibular alveolar ridges are always being a genuine challenge for dentists to attain an adequate oral rehabilitation
We present a case of an elderly male patient with severe mandibular alveolar ridge
The most important indication for this technique of distraction osteogenesis is a mandible with severe Atwood class 4 to 6 atrophy [11]
Summary
Resorbed mandibular alveolar ridges are always being a genuine challenge for dentists to attain an adequate oral rehabilitation. Dental implant surgery techniques have been successfully used for the treatment of such dilemma of severe atrophy [1]. In 2009, the Endo-Distractor Krenkel® was presented [8]. The screw of this simple device is anchored in the center of the bony arch and the osteotomized alveolar segment. It gently separates the bony segments gradually to a carefully chosen distance in the decided direction. We present a case of an elderly male patient with severe mandibular alveolar ridge. Krenkel® was used for bone regeneration in order to support a subsequent implant placement
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