Realization options

Bidirectional distraction of the mandibular body and ascending branch

• Patient-specific Zurich Bidirectional Distractor with individually fabricated plates
• Fixation with 1.5-mm standard screws

Transport distraction of the mandible

• Patient-specific ThreadLock Transport Distractor with individually fabricated plates and additively manufactured reconstruction plate
• Fixation with 1.5-mm standard screws

Multipart distraction of the cranium

• Patient-specific Posterior Cranial Vault Distractor with individually fabricated plates and additive manufactured fixation plate of the fronto-orbital ligament
• Fixation with 1.5-mm standard screws

Bilateral distraction of the maxilla

• Patient-specific drill and marking guide for Maxillary Telescoping Distractor

1. Virtual planning

To create the case the patient data and other case-related information are uploaded to the IPS Gate® web-based platform.
The data are prepared for case planning on the basis of information and requirements. An integrated chat function as well as web meetings are available for direct communication between the user and the IPS® developer. In consultation with the user, the drill and marking guides as well as the distractors optimized for the specific case are generated.
At the end the user approves the design for production.

2. Insertion of the guides and performing the osteotomy

After completing vestibular access, the drill and marking guides are inserted. The osteotomy line is defined using the cutting mark. Afterwards, the screws can be loosened again and the drill guide is removed again.
Osteotomy is now performed buccally using the marks. In adults it is also necessary to mobilize the mandible lingually, in the area of the osteotomy, with a chisel.

3. Fixation of the distractors

After ensuring mobility of the individual bone fragments, the distractor is attached with at least four screws on each side. The correct function of the distractor must be checked intra-operatively. It should be noted that the activator must remain accessible and movable after closing the suture.

Note:
In addition to the IPS® distractor, the respective activator must be available in a sterile condition in addition to the necessary osteo- synthesis accessories (KLS Martin osteosynthesis screws of the planned diameter as well as the matching twist drills and screw-drivers). They are not included in the IPS® package.

4. Latency period

After the implantation of a distraction system, a latency period must first be observed before the actual distraction period begins. The latency period is to be assessed by the surgeon depending on the indication and usually lasts approx. 5–7 days, depending on the patient.

5. Distraction period

Active distraction begins at the end of the latency period. The generally recommended distraction length per day is 1 mm. Active distraction is performed with a patient screwdriver (Ref. 51-500-90-07). One complete turn corresponds to 0.5 mm here. It is recommended to make one complete turn (360° = 0.5 mm) each morning and evening. This value always corresponds to that of the standard distractor. An arrow on the screwdrivers indicates the direction of activation.

6. Consolidation period

The consolidation period lasts approx. 8-12 weeks, depending on the patient. The distraction system may only be removed after complete bony development (consolidation) so as not to endanger the outcome of the distraction. However, the activator should be removed after the distraction period is completed. Remote Release Activators can be separated directly at the activation point after completion of the distraction period, while conventional activators must be detached from the distractor using special detachment forceps. Orthodontic treatment can already be started during the consolidation period.

7. Removal of the distractor

Once the consolidation period has been completed, all distractor components must be removed. The type and extent of postoperative treatment and/or rehabilitation measures are to be coordinated with the patient by the attending user.