Palate expansion distractor and method for manufacturing this distractor

Description

Technical area

[0001] The invention relates to a distractor for palate expansion, comprising an expansion part having at least two expansion elements adjustable at a distance from one another along a longitudinal axis, and two anchoring parts, each of which is fastened to an expansion element. Each anchoring part, divided into two sections by the longitudinal axis, has at least one palatal support and at least one tooth support on each of the two sections. Each palatal support has a support surface for contact with the palate and at least one through-hole provided in the region of the support surface for a fastening element for anchoring to a palatal bone of the palate. Each tooth support has a first contact surface for a, in particular palatal, lateral surface of a tooth and a second contact surface that projects beyond the first contact surface and forms a, in particular occlusal, tooth support for this tooth.in order to position the supporting surfaces on the palate. State of the art

[0002] A wide variety of distractors for palate expansion are known from the state of the art. All of these distractors feature an anchor in the patient's mouth, to which an expansion part of the distractor exerts a spreading force, thereby widening the palate.

[0003] For example, US 2016 / 0270884 A1 discloses a distractor that anchors itself to the teeth. The disadvantage, however, is that the spreading force is limited due to the grip of the teeth in the jaw, which restricts its application to growing patients whose palatal suture is not yet fully ossified. Greater spreading forces on the palate—for example, in adults—can be generated using distractors anchored to the palate via bone screws, as known, for example, from US 2009 / 0130620 A1. For this purpose, the distractor rests on the palate with a supporting surface, which is tightened to the palate via bone screws. However, these tensile forces are subject to narrow limits, both to ensure adequate fixation of the distractor to the palatal bone and to avoid overloading the palatal mucosa, as this can lead to significant inflammatory reactions throughout the oral cavity.In addition, these distractors require precise axial positioning relative to the palatal suture in order to exert a uniform spreading force along the length of the palatal suture.

[0004] To facilitate such axial positioning of distractors, a distractor with a combination of dental and palatal anchorage is known, for example, from DE 10 2016 121 196 B3. Similarly manageable distractors are known as MARPE (Miniscrew Aided Rapid Palatal Expansion) or MSE (Maxillary Skeletal Expander), etc.

[0005] Another distractor of this design is known as the "Power Expander" by Juan Carlos Perez Varela (XP055782221). This distractor, anchored to the palate with four bone screws, features a tooth support on each of its two anchoring parts, which, in addition to a palatal contact surface, also form an occlusal tooth support. For this purpose, the occlusal tooth support protrudes from the palatal contact surface. This tooth support of the "Power Expander" distractor facilitates positioning in the oral cavity or on the palate, just as with other distractors. However, even with this "Power Expander" solution, there is a risk of overloading the palate or the palatal mucosa at the support surface, which can lead to inflammatory reactions in the area of ​​the support surface and significantly impair the healing process.

[0006] Another distractor for palate expansion is known from MOON WON: "Class III treatment by combining facemask (FM) and maxillary skeletal expander (MSE)", SEMINARS IN ORTHODONTICS, Vol. 24, No. 1, March 2018, pages 95-107 (XP055780953). Description of the invention

[0007] The invention therefore has the task of developing a distractor for palate expansion based on the state of the art described at the beginning, such that it can be used safely and with a reduced risk of inflammatory reactions despite comparatively high spreading forces on a palatal suture.

[0008] The invention solves the problem by the features of claim 1.

[0009] If the anchoring parts each have at least two tooth supports, and where each section has at least one of the tooth supports and at least one of the palatal supports to which this tooth support is connected, the support surfaces can be fixed in their position on the palate particularly advantageously. In contrast to other palate-anchored distractors, the two tooth supports ensure that a support surface cannot move further towards the palate or undesirably press on the palatal mucosa, even due to the tensile forces of one or more bone screws. This prevents attachment-related pressure loads or crushing of the palatal mucosa and the associated inflammatory reactions in the area of ​​the support surfaces. The distractor according to the invention can therefore enable the desired healing process in a reproducible manner.

[0010] Furthermore, this positional fixation also facilitates anchoring the distractor, as the through hole in the palatal support acts as a stop when screwing in the bone screws, thus ensuring correct attachment to the palate at all times. The distractor according to the invention therefore not only ensures the desired healing process but is also relatively easy to anchor. Furthermore, this also increases treatment safety – especially when comparatively high spreading forces are required, for example, to expand the palate of a human patient, especially an adult.

[0011] In general, it is mentioned that the tooth supports can be part of a splint or can also be formed individually. In general, it is also conceivable that, for example, a connection, in particular a direct one, is formed via one arm or bar or multiple arms or bars. A plate can also be conceivable as a connection, in particular a direct one, by connecting, for example, the two tooth supports to the palate support. It is also mentioned that the term "in particular" should be understood as "for example."

[0012] The positional fixation of the support surface can be ensured even with comparatively high tightening forces of the bone screws if the palatal supports and tooth supports of the respective anchoring part are rigidly connected to each other - for example, in such a way that no deformation occurs when anchoring the distractor to the palate.

[0013] Preferably, the palatal supports and tooth supports are rigidly connected to each other in the respective anchoring component. This direct connection can be formed, for example, via one or more arms. A plate is also conceivable as a direct connection.

[0014] Preferably, the connection between the palate support and the tooth support of the respective anchoring component is designed to run without contact with the palate to prevent unwanted stress on the palatal mucosa, which can further improve the safety of use of the distractor. Furthermore, this can contribute to improved wearing comfort.

[0015] Preferably, the anchoring part has a first and a second arm, each connecting a tooth support to a palate support. This allows the distractor to be easily grasped and / or positioned, thus further facilitating handling of the distractor.

[0016] If the palate support is designed as an eyelet, this can further facilitate the handling of the distractor or simplify the construction of the distractor.

[0017] If the anchoring part has a first and a second arm, each connecting a tooth support to a palatal support, this mechanical coupling can further improve the positional fixation of the palatal support on the palate. This is especially true when the tooth support and palatal support are directly connected. Furthermore, it opens up the possibility of connecting the palatal support to the tooth support at any angle, thus allowing it to follow different palate contours. This can, among other things, contribute to improved anchoring to the palatal bone.

[0018] The latter is especially true if the palatal support is directly connected to the first or second arm. This can also lead to a particularly rigid mechanical connection between the tooth support and the palatal support, which can improve the stability of the position fixation.

[0019] Handling the distractor can be further facilitated if the dental support has a third arm that directly connects the palatal supports and is firmly attached to the respective expansion element. This also simplifies the distractor's design. Furthermore, it increases the adaptability of the palatal support to a wide range of inclinations, allowing it to follow different palate contours.

[0020] As an alternative to multiple arms, the connection can also include a bar. For this purpose, the tooth supports of each anchoring component are connected to the palatal supports via a common bar. This means that both sections of the respective anchoring component also share this bar. Among other things, this can reduce the material required for the anchoring component.

[0021] If the bar is divided into two legs, each connected to a palatal support, the design of the anchoring part can be further simplified. Furthermore, a slim anchoring part can be created for minimal palate coverage, which can, for example, improve wearing comfort.

[0022] If the legs are V-shaped towards each other, this can further promote the slim design of the anchoring part.

[0023] This is even more so if the respective expansion element is connected to the web, which is divided into the two legs in this area.

[0024] Preferably, each anchoring part has two palatal supports and / or two, three or four tooth supports in order to be able to position and anchor the distractor without tension.

[0025] The construction can be further simplified if the first tooth support has a molar band that forms the first contact surface.

[0026] The handling of the distractor can be further improved if the second tooth support has a half lingual band that forms the first contact surface.

[0027] If the anchoring parts are formed as a single piece, particularly by an additive manufacturing process, this ensures exact positioning and fixation of the distractor on the palate due to a comparatively high degree of dimensional accuracy.

[0028] The mechanical strength of the distractor can be further improved if the anchoring part is made of a cobalt-chromium-tungsten alloy, in particular Co63.9Cr24.7W5.5Mo5.0Si.

[0029] The fixation of the support surfaces in their position on the palate can be improved if the tooth supports of the two anchoring components located furthest outward from the longitudinal axis span a support surface between them, within which the palatal supports are arranged. For example, this can firmly prevent tilting when securing the distractor with palatal screws. This eliminates the risk of overloading the palate or the palatal mucosa at the support surface, thus preventing the healing process from being compromised.

[0030] To fix the position of the support surfaces on the palate, it may be sufficient if the first tooth support of each anchoring part is provided on a posterior molar and / or the second tooth support of each anchoring part is provided on a front molar.

[0031] In order to fix the position of the support surfaces on the palate, it may be sufficient if the first tooth support of each anchoring part is designed to be provided on a first tooth, which is a posterior molar, and / or the second tooth support of each anchoring part is designed to be provided on a second tooth, which is a front molar.

[0032] Preferably, the support surfaces of the palatal supports are designed to follow the contour of the palate, especially the palatal mucosa, which can further improve the desired course of treatment.

[0033] Preferably, the tooth supports are designed to follow the contour of the respective tooth, which can further improve the wearing comfort of the distractor.

[0034] The invention also has the object of creating a method with which the distractor according to the invention can be manufactured with precise shape.

[0035] The invention solves the problem by the features of claim 21.

[0036] If a digital image of at least a section of a patient's jaw is captured, the support surfaces and tooth supports are adapted to the digital image, and the anchoring parts with the adapted support surfaces and tooth supports are manufactured using an additive manufacturing process, a particularly high degree of precision fit of the distractor to the patient's jaw or palate is possible. This can particularly ensure the desired course of treatment. Brief description of the drawings

[0037] The figures show, for example, the subject matter of the invention in more detail using several embodiments. Fig. 1 a top view of a first distractor, positioned on a palate, according to a first embodiment, Fig. 2 a bottom view of the Fig. 1 shown distractor and Fig. 3 a side view of the distractor cut along III-III Fig. 1 and Fig. 4 a plan view of a second distractor, positioned on a palate, according to a second embodiment and Fig. 5 an enlarged plan view of the distractor according to Fig. 4 . Ways to implement the invention

[0038] After Fig. 1 the distractor 1 according to the invention is shown in a first embodiment without fastening elements, which is positioned on a replica of a palate 2 including the dental arch.

[0039] The distractor 1 comprises an expansion part 3 with two expansion elements 3a, 3b, the distance between which can be adjusted. This adjustment along a longitudinal axis L of the expansion part 3 is achieved via a spindle drive 3c, which engages both expansion elements 3a, 3b.

[0040] Furthermore, the distractor 1 has two anchoring parts 4, 5 with several palate supports 6a, 6b, 7a, 7b and several tooth supports 8a, 8b and 9a, 9b respectively.

[0041] The anchoring parts 4, 5 are each firmly connected to or attached to an expansion element 3a, 3b of the distractor 1.

[0042] The several, in the embodiment four, palatal supports 6a, 6b, 7a, 7b serve to anchor the distractor 1 to the palate 2. On each anchoring part 4 or 5, two palatal supports 6a, 6b or 7a, 7b are provided, namely one palatal support 6a, 6b, 7a or 7b on a section 4a, 4b or 5a, 5b of the respective anchoring part 4 or 5, wherein the two sections 4a, 4b or 5a, 5b result from a division of the respective anchoring part 4 or 5 on the longitudinal axis L of the expansion part 3, which according to Fig. 2 is shown in more detail.

[0043] The palatal supports 6a, 6b, 7a, 7b each have a supporting surface 10, via which the distractor 1 rests on the palate 2 or the palatal mucosa. These circular supporting surfaces 10 are in the Fig. 2 In the area of ​​the supporting surfaces 10 of the palatal supports 6a, 6b, 7a, 7b, a through hole 11 is also provided, through which - as for example according to Fig. 3 As shown, four bone screws 100 serve as fastening elements to anchor the distractor 1 to the palate 2. To ensure that this anchoring takes place in the exact position on the palate 2, the distractor 1 has several tooth supports 8a, 8b and 9a, 9b.

[0044] Each tooth support 8a, 8b, 9a, 9b has a first contact surface 13a for a palatal side surface of a first tooth 12.1, which is a posterior molar, and a second contact surface 13b, which projects beyond the first contact surface 13a and forms an occlusal tooth support for this tooth 12.1 - see in particular Figur 3 . Using these tooth supports 8a, 8b, 9a, 9b, the support surface 10 can now be positioned on the palate 2 - and thus the distractor 1 can be aligned on the palate 2.

[0045] According to the invention, this abutment of the support surfaces 10 on the palate 2 is also fixed in position in that the anchoring parts 4, 5 each have at least two tooth supports 8a, 8b, 9a, 9b for each tooth 12.1, 12.2, and wherein in each section 4a, 4b or 5a, 5b at least one tooth support 8a, 8b, 9a, 9b is connected to a palate support 6a, 6b, 7a, 7b - see in particular Figuren 1 , 2 or 4, 5.

[0046] Both sections 4a, 4b and 5a, 5b of the respective anchoring part 4 and 5 therefore each have a tooth support 8a, 8b, 9a, 9b and a palate support 6a, 6b, 7a, 7b and are thus fixed in position together with their palate supports 6a, 6b and 7a, 7b, respectively, or the support surfaces 10 are thus fixed in their position on the palate 2.

[0047] After Fig. 1 Of the tooth supports 8a, 8b, 9a, 9b, on the one hand, the first tooth supports 8a, 9a are provided for the first tooth 12.1, which is a back molar (molar), and on the other hand, the second tooth supports 8b, 9b are provided for the second tooth 12.2, which is a front molar (premolar).

[0048] A tightened fastener cannot therefore pull the support surfaces 10 toward the palate 2, thus always avoiding stress on the palatal mucosa. Therefore, there is no risk of developing inflammatory reactions in the palatal mucosa in the area of ​​the support surfaces 10, which can significantly adversely affect the healing process.

[0049] This is particularly true because the support surfaces 6a, 6b, 7a, 7b of the palatal supports are each designed to follow the contour of the palatal mucosa of the palate 2, specifically where they rest against the palate 2. The wearing comfort of the distractor 2 is particularly high because the tooth supports 8a, 8b, 9a, 9b are each designed to follow the contour of the respective tooth 12.1, 12.2.

[0050] This inventive design also opens up the possibility of positioning the through holes 11 of the palatal supports 6a, 6b, 7a, and 7b relative to each other in a special way. For example, these through holes 11 can be provided within a molar box (or in the palate section between the opposing molar teeth) and at the same distance from the median palatal suture of the maxilla on the distractor 1. This guarantees reliable treatment success.

[0051] As after Fig. 1 As can be seen, the palatal supports 6a, 6b, 7a, 7b and the tooth supports 8a, 8b and 9a, 9b are rigidly connected to one another via a first and second arm 15a and 15b, respectively. This allows the palatal supports 6a, 6b, 7a, 7b to be provided with different angles of inclination to the palate 2 and are thus particularly adaptable to the shape of the palate 2. In particular, their inclination can also be adjusted so that the fastening elements experience a greater overlap with the palatal bone, thus improving the fixation of the distractor 1.

[0052] Structurally simple, the palatal supports 6a, 6b, 7a, 7b are connected directly to the arm 15a, 15b in the form of an eyelet 16. A third arm 15c is connected to the respective palatal supports 6a, 6b, 7a, 7b of the anchoring part 4 or 5 - as shown in Fig. 2 can be seen.

[0053] This third arm 15c is firmly connected to the respective expansion element 3a, 3b - namely materially bonded via Fig. 2 schematically illustrated welded joints. This allows the anchoring parts 4 and 5 to be formed in one piece, independently of the expansion part 3, for example, through an additive manufacturing process. This allows for precise adaptation of the anchoring parts 4 and 5 to the palate 2. Preferably, at least the support surfaces 10 or the anchoring parts 4 and 5 are electropolished. The anchoring parts 4, 5 are preferably made of a cobalt-chromium-tungsten alloy—preferably Co63.9Cr24.7W5.5Mo5.0Si.

[0054] In addition, the Fig. 2 It can be seen that the first tooth support 8a, 9a of an anchoring part 4 or 5 has a molar band that forms the first contact surface 13a. The occlusal tooth support adjoins the molar band. The second tooth support 8b or 9b of an anchoring part 4 or 5 has a half lingual band that forms the first contact surface 13a. The occlusal tooth support 13b adjoins the half lingual band.

[0055] The four bone screws 100 ensure easy-to-use anchoring of the distractor 1. The respective bone screw 100 passes through the through hole 11 of the respective tooth support 8a, 8b, 9a, 9b, wherein the through hole 11 has an end section 11b tapering conically from the hole edge 11a, as shown for example in the Fig. 3 for the tooth support 8a.

[0056] This end section 11b serves as a stop for the bone screw 100, namely as a stop for a truncated cone-shaped head section 102 on the screw head 101 of the bone screw 100. Overtightening of the bone screw 100 is therefore impossible. Preferably, the tooth supports 8a, 8b, 9a, 9b are glued to the respective tooth, and then the distractor 1 is anchored to the palate 2 with the bone screws 100.

[0057] The bone screw 100 also has an external thread 104 on the shaft 103 and a flattened portion 105 on the shaft end. Furthermore, the bone screw 100 has an internal cone on the head, which allows the bone screw 100 to be easily operated.

[0058] After Fig. 4 and Fig. 5 a further distractor 51 according to the invention according to a second embodiment without fastening elements is shown in plan view.

[0059] In contrast to distractor 1 of the Figuren 1 bis 2 , the anchoring parts of the distractor 51 have differently constructed anchoring parts 4, 5. Thus, their connection between the respective tooth supports 8a, 8b or 9a, 9b and the palate supports 6a, 6b or 7a, 7b is different.

[0060] For each anchoring part 4, 5, a common web 55 or 56 is provided, which extends from the tooth supports 8a, 8b or 9a, 9b, connects to the respective expansion element 3a, 3b and there divides into two legs 55a, 55b or 56a, 56b, which each connect to a palate support 6a, 6b or 7a, 7b, as shown in particular in Fig. 5 to recognize.

[0061] These connections between the respective tooth supports 8a, 8b and 9a, 9b and the palatal supports 6a, 6b and 7a, 7b are Y-shaped, resulting in particularly compact anchoring parts 4, 5. This, among other things, increases the wearing comfort of the distractor 51.

[0062] In addition, the distractor 51 has four tooth supports 8a, 8b and 9a, 9b per anchoring part 4, 5, resulting in a particularly wide support surface 60. This support surface 60 is spanned between the tooth supports 8a, 8b, 9a, 9b of the two anchoring parts 4, 5 that are located furthest outward relative to the longitudinal axis L. The palatal supports 6a, 6b, 7a, 7b are arranged within the support surface 60, which results in high stability in the positional fixation of the distractor or the palatal supports 6a, 6b, 7a, 7b relative to the palate.

[0063] But in this distractor 51, too, the anchoring parts 4, 5 each have at least two, namely four, tooth supports 8a, 8b, 9a, 9b. Similar to the distractor 1, each subsection 4a, 4b or 5a, 5b of the anchoring parts 4, 5 has at least one of the tooth supports 8a, 8b or 9a, 9b and at least one of the palate supports 6a, 6b or 7a, 7b. In this case, the first subsection 4a, 5a has a first tooth support 8a on a first tooth 12.1, and the second subsection 4b, 5b has two second tooth supports 8b each on a second tooth 12.2. A first tooth support 8a on a tooth 12.1 is common to these two subsections 4a, 5b.

[0064] It is also conceivable to have three tooth supports 8a, 8b or 9a, 9b per anchoring part 4, 5, which has not been shown in more detail.

[0065] To manufacture a distractor 1, 51, a digital image of a patient's jaw is advantageously captured. The support surfaces 10 and tooth supports 8a, 8b, 9a, 9b are adapted to the digital image of the jaw, ensuring a high degree of precision fit for the distractor 1, 51. Preferably, the anchoring parts 4, 5 with the adapted support surfaces 10 and tooth supports 8a, 8b, 9a, 9b are manufactured using an additive manufacturing process, which simplifies the manufacturing process and accelerates the production of the distractor 1, 51 despite the high degree of individuality due to different jaw shapes.

Claims

1. Distractor for palatal expansion, with an expansion part (3) that has at least two expansion elements (3a, 3b) spaced apart from each other that are adjustable along a longitudinal axis (L) and with two anchoring parts (4, 5) that are each fastened to a respective expansion element (3a, 3b), wherein each anchoring part (4, 5) that is divided into two subsections (4a, 4b and 5a, 5b, respectively) by the longitudinal axis (L) has at least one palate rest (6a, 6b, 7a, 7b) and at least one tooth support (8a, 8b, 9a, 9b) in each of the two subsections (4a, 4b and 5a, 5b, respectively), wherein each palate rest (6a, 6b, 7a, 7b) has a support surface (10) for contacting the palate (2) and at least one through hole (11) provided in the region of the support surface (10) to accommodate a fastening element for anchoring to a palatine bone of the palate (2), wherein each tooth support (8a, 8b, 9a, 9b) has a first contact surface (13a) for an palatal side surface of a tooth (12.1, 12.2) and a second contact surface (13b), which overhangs the first contact surface (13a) and forms an occlusal tooth rest for this tooth (12.1, 12.2), in order to thus position the support surfaces (10) against the palate (2), wherein the anchoring parts (4, 5) each have at least two tooth supports (8a, 8b, 9a, 9b) and wherein each subsection (4a, 4b and 5a, 5b, respectively) has at least one of the tooth supports (8a, 8b and 9a, 9b, respectively) and at least one of the palate rests (6a, 6b and 7a, 7b, respectively) to which this tooth support (8a, 8b and 9a, 9b, respectively) is connected in order to thus fix the support surfaces (10) in their position against the palate (2).

2. Distractor according to claim 1, characterized in that palate rests (6a, 6b, 7a, 7b) and tooth supports (8a, 8b, 9a, 9b) of the respective anchoring part (4, 5) are directly connected to each other, more particularly in a rigid way.

3. Distractor according to claim 1 or 2, characterized in that the connection between the palate rests (6a, 6b, 7a, 7b) and tooth supports (8a, 8b, 9a, 9b) of the respective anchoring part (4, 5) is embodied as extending in such a way that it does not contact the palate (2).

4. Distractor according to one of claims 1 to 3, characterized in that the palate rest (6a, 6b, 7a, 7b) is embodied as an eyelet (16).

5. Distractor according to one of claims 1 to 4, characterized in that the anchoring part (4, 5) has a first and second arm (15a, 15b), which each connect a tooth support (8a, 8b, 9a, 9b) to a palate rest (6a, 6b, 7a, 7b), more particularly in a direct way.

6. Distractor according to claim 4 and 5, characterized in that the palate rest (6a, 6b, 7a, 7b) adjoins the first or second arm (15a, 15b, 15c) directly.

7. Distractor according to claim 5 or 6, characterized in that the tooth support (8a, 8b, 9a, 9b) has a third arm (15c), which connects the palate rests (6a, 6b, 7a, 7b) directly and is firmly connected to the respective expansion element (3a, 3b).

8. Distractor according to one of claims 1 to 4, characterized in that in each anchoring part (4, 5), the tooth supports (8a, 8b and 9a, 9b, respectively) are connected to the palate rests (6a, 6b and 7a, 7b, respectively) by means of a shared connector piece (55, 56).

9. Distractor according to claim 8, characterized in that the connector piece (55, 56) splits into two legs (55a, 55b and 56a, 56b, respectively), which each adjoin a palate rest (6a, 6b and 7a, 7b, respectively).

10. Distractor according to claim 8 or 9, characterized in that the legs (55a, 55b and 56a, 56b, respectively) extend in a V shape in relation to each other and / or the respective expansion element (3a, 3b) adjoins the connector piece (55, 56), which splits into the two legs (55a, 55b and 56a, 56b, respectively) in this region.

11. Distractor according to one of claims 1 to 10, characterized in that each anchoring part (4, 5) has two palate rests (6a, 6b, 7a, 7b) and / or two, three, or four tooth supports (8a, 8b, 9a, 9b).

12. Distractor according to one of claims 1 to 11, characterized in that the first tooth support (8a, 9a) has a molar band, which constitutes the first contact surface (13a).

13. Distractor according to one of claims 1 to 12, characterized in that the second tooth support (8b, 9b) has a half-lingual band that constitutes the first contact surface (13a).

14. Distractor according to one of claims 1 to 13, characterized in that the anchoring parts (4, 5) are embodied of one piece, more particularly embodied of one piece by means of an additive production method.

15. Distractor according to one of claims 1 to 14, characterized in that the through hole (11) has an end section (11b) tapering conically from the hole edge (11a).

16. Distractor according to one of claims 1 to 15, characterized in that the anchoring parts (4, 5) consists of a cobalt-chromium-tungsten alloy, more particular Co63,9Cr24,7W5,5Mo5.0Si.

17. Distractor according to one of claims 1 to 16, characterized in that the tooth supports (8a, 8b, 9a, 9b) of the two anchoring parts (4, 5) situated the farthest toward the outside relative to the longitudinal axis define a support plane (60) between themselves, within which the palate rests (6a, 6b, 7a, 7b) are positioned.

18. Distractor according to one of claims 1 to 17, characterized in that the first tooth support (8a, 9a) of each anchoring part (4, 5) is embodied so that it can be provided at a first tooth (12.1), which is a molar, and / or the second tooth support (8b, 9b) of each anchoring part (4, 5) is embodied so that it can be provided at a second tooth (12.2), which is a premolar.

19. Distractor according to one of claims 1 to 18, characterized in that the support surfaces (10) of the palate rests (6a, 6b, 7a, 7b) are each embodied so that they follow the contour of the palate (2) and / or the tooth supports (8a, 8b, 9a, 9b) are each embodied so that they follow the contour of the relevant tooth (12.1, 12.2).

20. Method for producing a distractor (1, 51) according to one of claims 1 to 19, characterized in that a digital image is taken of at least one section of a patient's jaw, the support surfaces (10) and tooth supports (8a, 8b, 9a, 9b) are adapted to the digital image and, with the aid of an additive production method, the anchoring parts (4, 5) are produced with the adapted support surfaces (10) and tooth supports (8a, 8b, 9a, 9b).