Edentulousness paired with severe mandibular bone loss continues to be a challenge for implant dentists. Ridge augmentation with autogenous bone requires major surgery. Distraction osteogenesis (DO), by contrast, regenerates the local bone stock with all of its genetic determinants. It is thus tantamount to targeted bioengineering of the region of interest.

Results of the Standard MONO Endo-Distractor in 44 patients treated between mid-2003 and early 2010 are presented. Their mean age was 61 (61 + 8.66) years with a first peak prior to age 50 and the bulk of the patients beyond age 60 years. The sex distribution showed a major imbalance in favor of females (40 females versus 4 males). Targeted distraction (9.2 mm; 4–13) of edentulous highly atrophic mandibles was followed by the placement of 4 interforaminal implants and implant-supported prosthodontic rehabilitation. Mono endodistraction is a new approach to DO: Mid-bone placement of abutment-like distractor; distraction screw in basal cortical bone; negligible tilting (3.38 + 2.33°); sealed against saliva and bacteria; metal removal without surgery. 152 dental implants were placed supporting custom-milled bars with overdentures or fixed screw-down bridges. The mean follow-up time was 3 years.

Complications like mandibular fractures or infections were reduced to one quarter of those in a first study treated by the TWIN Endo-Distractor. Major bone regeneration was observed during functional loading even posteriorly. Together with ridge repair, the vestibulum and the esthetics of the lip and chin were restored. The MINI/MIKRO Endo-Distractor for closing gaps produced promising 1-year results.

Conflict of interest: None declared.