Endo-distraction in atrophic mandibles as a basis for reliable preprosthetic implantology

Stabilization of pathological fractures in highly atrophic mandibles caused by peri-implantitis is always challenging. Two such cases led us to develop new procedures in preprosthetic surgery for the treatment of highly atrophic mandibles. Distraction osteogenesis represents a surgical method that is able to solve the problem of mandibular atrophy. Instead of the traditional use of intraoral plate distractors, intraosseous distractors have been developed to enable distraction according to the intended vector and to avoid secondary surgery for removal of hardware. Further development with endo-distraction would solve the problem of lingual tilting, resulting in a procedure with maximum efficacy. Surgical experience with 109 patients over a period of 14 years helped us to optimize the procedure and standardize the results. This article details a typical case and explains the procedure in detail.