WO2003079912A1 - Distraktionsgerät for die osteogenese - Google Patents
Distraktionsgerät for die osteogenese Download PDFInfo
- Publication number
- WO2003079912A1 WO2003079912A1 PCT/DE2003/000741 DE0300741W WO03079912A1 WO 2003079912 A1 WO2003079912 A1 WO 2003079912A1 DE 0300741 W DE0300741 W DE 0300741W WO 03079912 A1 WO03079912 A1 WO 03079912A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- distraction osteogenesis
- anchors
- nut
- elements
- thread
- Prior art date
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/60—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like for external osteosynthesis, e.g. distractors, contractors
- A61B17/66—Alignment, compression or distraction mechanisms
- A61B17/663—Alignment, compression or distraction mechanisms for jaw bones, e.g. subcutaneous distractors with external access
- A61B17/666—Alignment, compression or distraction mechanisms for jaw bones, e.g. subcutaneous distractors with external access for alveolar distraction
Definitions
- the invention relates to a device for distraction osteogenesis with a drive having a threaded spindle and two anchors displaceable relative to one another by the drive, one of which can be connected to a fixed bone segment and one to a movable bone segment.
- a sub-area of maxillofacial surgery includes the reconstruction of bone structures. Such measures are required in a number of diseases, such as severe cases of cleft lip and palate, but also Crouzon or aperous syndromes. In addition, the treatment of bone defects after trauma or tumor surgery is dependent on the reconstruction of bones.
- a newer method of reconstructing bone structures has become known as distraction osteogenesis. Instead of implanting tissue, this procedure uses bone weave newly won. The basis for this procedure was laid by the Russian orthopedic surgeon llizarov in 1988 and led to a method for the elongation of long bones. This is based on pulling apart a callus formed after corticotomy at a speed of about one millimeter per day. This activates the self-healing powers of the bone, so that new callus tissue is continually being produced, thereby lengthening the long bones.
- Distraction osteogenesis has developed into an important therapeutic procedure in oral, maxillofacial and facial surgery.
- it is used to vertically build edentulous or tooth-bearing alveolar extension segments and highly atrophic mandibles in the anterior, posterior or in the area of the entire mandible.
- distraction devices are used which have the task of continuously displacing a bone segment covering the reconstruction area, which was previously surgically separated from the residual bone, with respect to the residual bone.
- the permanent displacement of the bone segment has the consequence that the callus that forms between the shores of the displaced and fixed bone is permanently enlarged and new bone tissue is thus obtained.
- Practice has shown that the smaller the distraction steps, the more intense the formation of callus, i.e.
- the object of the invention is to provide a device for distraction osteogenesis which avoids the disadvantages mentioned, and in particular ensures exact guidance of the anchors which can be moved relative to one another, even with small dimensions of the device.
- the proposed device also allows it to be used as a dental implant post which remains in the patient's jaw.
- the drive is designed as a linear drive, by means of which two elements are translationally displaceable relative to one another without rotation, and one of said anchors is fixed at the first end of one element and the other of said anchors is fixed at the first end of the other element.
- the present distractor has a drive and two anchors which can be displaced relative to one another by the drive.
- the drive is not designed as a simple screw drive, but as a linear drive. This design ensures that the two main elements of the drive can be shifted purely translationally without rotation to one another.
- the mentioned anchors are fixed at one end of the two elements.
- one anchor is connected to the displaceable bone segment, the other to the fixed bone.
- the exact guidance inherent in the drive is thus also transferred to the two anchors and thus to the relative movement between the two bones.
- the distraction therefore takes place in a precisely predetermined direction.
- the advantageous consequence of this is that the shape of the callus formed corresponds to the planned shape at any point in time of use.
- the new bone area emerging from the callus therefore has exactly the planned shape and size after completion of the treatment.
- the anchors have plate-shaped regions which, in a preferred embodiment, are oriented perpendicular to the direction of displacement. This configuration advantageously ensures exact support of one anchor on the fixed bone and exact support of the bone segment to be displaced by the other anchor.
- the movable bone segment is displaced perpendicularly to the plate-shaped regions of the anchors and is therefore exactly predetermined.
- the invention provides several advantageous solutions.
- a first solution has anchors in which the plate-shaped regions are arranged eccentrically to the linear drive. This configuration means that the linear drive comes to rest in the edge region of the armature. It enables an advantageous use of the distractor, in which the plate-shaped region of at least one of the two anchors is inserted into a slot leading from the outside into the bone segment in question, while the linear drive remains outside the bone.
- the advantage of this design is the fact that the distractor can be attached and removed from the outside with comparatively little effort.
- This type of incorporation also leads to the plate-shaped region of the anchor in question being given a very stable fit in the bone.
- the direction of distraction in the application mentioned is perpendicular to the orientation of the slot and, since the orientation of the slot can be specified very precisely, can also be determined very precisely in an advantageous manner.
- the thickness of the plate-shaped area of at least one armature tapers at least at the edges pointing away from the linear drive.
- the wedge-shaped edges are then pressed into the bone substance.
- the outer surface of the linear drive is also wedge-shaped in the direction facing the eccentrically arranged plate-shaped areas.
- the invention provides two variants, a first in which both elements have a non-circular, preferably square, cross section, and a second in which both elements have a round cross section.
- one of the elements is equipped with a longitudinal groove in which a pin rigidly connected to the other element engages. It is equivalent to the element on which the groove is provided and the element on which the pin is fixed.
- the linear drive is adjusted from the second end of the two elements.
- the invention provides two variants.
- the outer of the two elements in the region of its second end is equipped with an internal thread, in which a nut with an external thread engages.
- the mother in turn, has a concentrically arranged blind hole which overlaps the second end of the inner element with little play.
- turning the nut clockwise causes the nut to disappear continuously into the internal thread.
- the outer element since it is supported on the second end of the inner element which engages in the blind hole, the outer element is continuously displaced towards its second end in this process.
- the anchors attached to the two first ends of the elements are moved away from each other, thus continuously increasing the distance between the freely movable bone segment and the fixed bone.
- the roles of the inside and outside element are reversed. Accordingly, the interior of the two elements has an external thread in the region of its second end, into which a nut with an internal thread engages.
- the mother is in turn rotatably attached to the outer element. In the case of a right-hand thread, a rotation of the nut counterclockwise leads to the nut and thus the outer element attached to it being continuously displaced towards its second end.
- the associated relative movements of the anchors fixed to the elements correspond to those of the aforementioned variant.
- the attachment of the armature to the first end of the elements of the linear drive mentioned allows several design options. It is advantageous for the use of the device for osteogenesis according to the invention to fix the anchors in each case by means of a thread at the first end of the respective element.
- the thread on the one hand ensures a secure and rigid connection, but allows the possibility of separating the armature and the above-mentioned elements of the linear drive from each other.
- the latter option is of interest if the components of the distraction device are to be removed again after the end of the treatment. In this case, the screw connection between anchors and linear elements is loosened in order to subsequently remove the components of the device from the treatment area.
- the direction of rotation of the existing threads is suitably matched to one another.
- the thread of the nut and the anchor mentioned in the same direction, preferably as a right-hand thread.
- the thread of the nut and the anchor mentioned are each designed in opposite directions.
- a solution is preferred in which the thread of the nut is designed as a right-hand thread and the thread of the anchors mentioned is in each case designed as a left-hand thread.
- the material of the device is made of precious metal.
- a feature of the invention provides for the components to be produced from gold or platinum.
- the invention provides both an application of the proposed device in which it is removed again after the distraction is complete, and an application in which the device or components thereof remain in the patient's body.
- the latter case is of interest if the osteogenesis is connected with a subsequent reconstruction of the dentition.
- the advantage of this solution is obvious, it saves further interventions in the jaw that serve to produce the dentition after the distraction treatment has been completed.
- anchors are formed centrally to the linear drive.
- Anchors with a plate-like geometry are preferred, recesses being generally provided within the plate, which have a symmetry of two, three or more numbers with respect to the axis of the linear drive.
- anchors with a star-shaped geometry are preferably used, which also have a symmetry with two, three or more numbers.
- the anchors are arranged eccentrically to the linear drive and are designed as plate-shaped elements.
- the plate-shaped area of the anchors is preferably each in the form of a U.
- the invention provides different ways of fixing the anchors.
- the plate-shaped regions of both anchors are arranged in the joint between the movable and fixed bone segment.
- Another application is characterized in that the plate-shaped area of at least one of the two anchors is incorporated into the respective bone segment. A particularly stable fit of the distraction device can be achieved in particular if both anchors are incorporated within the bone tissue.
- Figure 1a a longitudinal section through the device
- Figure 1 b a section along the section plane AB of Figure 1a.
- Figure 2 shows a longitudinal section through a variant of the device
- the basic structure of the distractor can be seen in FIG.
- the essential components include a linear drive with the elements 1 and 2 and the armatures 3 and 4 attached to their respective first ends 1a, 2a.
- the elements run elements 1, 2 telescopically one inside the other, element 1 forming the inner element, element 2 the outer element. Both elements have a non-circular cross-section, element 1 a square and element 2 that of a square square tube.
- the selected design of the linear drive ensures that the two elements 1, 2 of the drive can be displaced purely translationally without rotation to one another.
- the adjustment of the linear drive is carried out by means of the adjustment head 5 from the second end 1b, 2b of the two elements 1, 2.
- the adjustment head 5 comprises a nut 6, which is equipped with an internal thread and is screwed onto the inner element 2.
- the element 2 therefore has a corresponding external thread 7 in the region 8 of its second end 2b.
- the nut 6 is in turn rotatably attached to the second end 2b of the outer element 2.
- the definition of the type mentioned is indicated in the present illustration by the two brackets 9, 9 '.
- one anchor 4 When using the device for distraction osteogenesis, one anchor 4 is connected to the displaceable bone segment (not shown), the other 3 to the fixed bone (not shown). The exact guidance of the linear drive results in an equally exact movement of the displaceable bone segment.
- an increase in the distance 10 between the two anchors 3, 4 then leads to the fact that the callus formed between the shores of the displaced and fixed bone is permanently enlarged and thus new bone tissue is obtained.
- the anchors 3, 4 have plate-shaped regions 11 which ensure exact support of the one anchor 3 on the fixed bone and exact support of the bone segment to be displaced by the other anchor 4.
- the anchors 3, 4 are each fastened to the first end 1a, 2a of the respective element 1, 2 by means of a thread 12, 13. This type of fastening permits the possibility of separating the armatures 3, 4 and the elements 1, 2 of the linear drive from one another and is recommended if the components of the distraction device are to be removed again after the treatment has ended.
- FIG. 2 shows a variant of the device in which the linear drive has a sleeve 22 with a round inner cross section and a telescoping pin 21 with a round outer cross section.
- a longitudinal groove 23 in the pin 21, in which a pin 24 rigidly connected to the sleeve 22 engages, ensures that both elements 21, 22 do not rotate against one another when the linear drive is adjusted.
- the adjustment of the linear drive is effected by a nut 25, which is seated on the second end 21 b of the pin 21 and meshes with an internal thread of the sleeve 22.
- the external thread of the nut 25 and the internal thread of the sleeve 22 are not shown in the drawing for the sake of clarity.
- the nut 25 is actuated by a screwdriver (not shown) which engages in a slot 27 in the nut 25 through a bore 26 in the end 22b of the sleeve 22.
- the through The diameter of the bore 26 is dimensioned such that a collar 28 extending over the nut 25 is retained on the sleeve.
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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Medical Informatics (AREA)
- General Health & Medical Sciences (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- Engineering & Computer Science (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
- Prostheses (AREA)
- Medicines Containing Material From Animals Or Micro-Organisms (AREA)
- Orthopedics, Nursing, And Contraception (AREA)
- Materials For Medical Uses (AREA)
Abstract
Description
Claims
Priority Applications (5)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
AU2003223849A AU2003223849A1 (en) | 2002-03-22 | 2003-03-08 | Distraction device used for osteogenesis |
DE50303366T DE50303366D1 (de) | 2002-03-22 | 2003-03-08 | Distraktiongsgerät für die osteogenese |
EP03720150A EP1489979B1 (de) | 2002-03-22 | 2003-03-08 | Distraktiongsgerät für die osteogenese |
US10/508,606 US8092463B2 (en) | 2002-03-22 | 2003-03-08 | Distraction device used for osteogenesis |
CA002480261A CA2480261A1 (en) | 2002-03-22 | 2003-03-08 | Distraction device used for osteogenesis |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE10212815A DE10212815A1 (de) | 2002-03-22 | 2002-03-22 | Distraktionsgerät für die Osteogenese |
DE10212815.4 | 2002-03-22 |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2003079912A1 true WO2003079912A1 (de) | 2003-10-02 |
Family
ID=27798069
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/DE2003/000741 WO2003079912A1 (de) | 2002-03-22 | 2003-03-08 | Distraktionsgerät for die osteogenese |
Country Status (10)
Country | Link |
---|---|
US (1) | US8092463B2 (de) |
EP (1) | EP1489979B1 (de) |
AT (1) | ATE326179T1 (de) |
AU (1) | AU2003223849A1 (de) |
CA (1) | CA2480261A1 (de) |
DE (2) | DE10212815A1 (de) |
DK (1) | DK1489979T3 (de) |
ES (1) | ES2264528T3 (de) |
PT (1) | PT1489979E (de) |
WO (1) | WO2003079912A1 (de) |
Cited By (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
FR2867965A1 (fr) | 2004-03-23 | 2005-09-30 | Gerard Scortecci | Dispositif de distraction de l'os d'une machoire |
US20100241126A1 (en) * | 2006-10-11 | 2010-09-23 | Ignace Ghijselings | Device and method for installing femoral prosthetic knee joint |
WO2015185601A1 (de) * | 2014-06-04 | 2015-12-10 | Celgen Ag | Distraktionsimplantat mit distanzstegen |
Families Citing this family (12)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE20304365U1 (de) * | 2003-03-12 | 2004-07-22 | Dr. Ihde Dental Ag | Knochen- und Weichteildistraktor |
DE102008019389A1 (de) | 2008-04-17 | 2009-10-22 | Fangmann, Rainer, Dr. | Dental-Distraktor |
DE102010015687A1 (de) | 2010-04-21 | 2011-10-27 | Ernst Fuchs | Magnetisch bewegter Distraktor für die Osteogenese |
DE102010017023A1 (de) * | 2010-05-19 | 2011-11-24 | Dieter Derichs | Vorrichtung zur Distraktion von Knochensegmenten |
DE102011001959B3 (de) | 2011-04-11 | 2012-08-30 | Dieter Derichs | Distraktionssystem |
EP2735276B1 (de) * | 2012-11-27 | 2018-09-05 | Stryker European Holdings I, LLC | Pädiatrischer interner Mandibulardistraktor |
DE102012024205B4 (de) | 2012-12-05 | 2016-09-15 | Celgen Ag | Implantat zur Knochendistraktion |
DE102014001387A1 (de) * | 2014-01-29 | 2015-08-13 | Celgen Ag | Distraktionsimplantat mit asymmetrischer Membran |
DE102014001378B3 (de) * | 2014-01-29 | 2015-06-25 | Celgen Ag | Distraktionsimplantat mit vorwärts und rückwärts schneidendem Gewinde |
US10166053B2 (en) | 2014-12-30 | 2019-01-01 | Stryker European Holdings I, Llc | Distractor with bidirectional rotation control |
ES2597965B1 (es) * | 2015-07-24 | 2017-10-31 | Fermoinvers, S.L. | Dispositivo de fijación del fragmento móvil para técnicas de distracción alveolar en implantología dental |
CN105286968B (zh) * | 2015-11-05 | 2019-07-26 | 重庆医科大学附属口腔医院 | 适用于狭小空间的牵张成骨器 |
Citations (4)
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DE19537023A1 (de) * | 1994-10-05 | 1996-04-11 | Medicon Eg Chirurgiemechaniker | Distraktionsvorrichtung |
WO1997020512A1 (en) * | 1995-12-01 | 1997-06-12 | Walker David A | Telescopic bone plate for use in bone lenghtening by distraction osteogenesis |
US5810812A (en) * | 1996-10-16 | 1998-09-22 | Chin; Martin | Apparatus and method for submergible self-retaining mandibular distractor |
WO2000056235A1 (en) * | 1999-03-23 | 2000-09-28 | Synthes Ag Chur | Orthopedic system having detachable bone anchors |
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US918579A (en) * | 1908-05-23 | 1909-04-20 | Abraham J Murch | Telescopic clothes-pole. |
US4501266A (en) * | 1983-03-04 | 1985-02-26 | Biomet, Inc. | Knee distraction device |
US5112333A (en) * | 1990-02-07 | 1992-05-12 | Fixel Irving E | Intramedullary nail |
US5213112A (en) * | 1992-01-29 | 1993-05-25 | Pfizer Hospital Products Group, Inc. | Tension meter for orthopedic surgery |
US5505733A (en) * | 1993-10-22 | 1996-04-09 | Justin; Daniel F. | Intramedullary skeletal distractor and method |
US5597379A (en) * | 1994-09-02 | 1997-01-28 | Hudson Surgical Design, Inc. | Method and apparatus for femoral resection alignment |
DE19500202A1 (de) * | 1995-01-05 | 1996-07-18 | Oraltronics Marketing Und Vert | Distraktor, insbesondere zur kranio-fazialen Kallusdistraktion |
US5540696A (en) * | 1995-01-06 | 1996-07-30 | Zimmer, Inc. | Instrumentation for use in orthopaedic surgery |
GB2306653B (en) * | 1995-10-23 | 1999-12-15 | Finsbury | Surgical tool |
US5669914A (en) * | 1996-02-16 | 1997-09-23 | Board Of Regents Of The University Of Colorado | Rotation alignment instrument |
CH692898A5 (de) * | 1998-05-13 | 2002-12-13 | Straumann Inst Ag | Distraktionsvorrichtung zur Knochenaugmentation. |
DE19822802C2 (de) * | 1998-05-20 | 2001-11-08 | Medicon Eg Chirurgiemechaniker | Vorrichtung zur Distraktion von Knochensegmenten, insbesondere im Kieferbereich |
US6306143B1 (en) * | 1999-01-19 | 2001-10-23 | Nobel Biocere Ab | Distraction osteogenesis fixture |
DE29921046U1 (de) * | 1999-11-30 | 2000-05-11 | Leibinger Medizintech | Knochendistraktor |
EP1120090A1 (de) * | 2000-01-17 | 2001-08-01 | P.J. Wolgen | Distraktionsorrichtung für Gesichts- und Kieferchirurgie |
DE20008796U1 (de) * | 2000-05-16 | 2000-08-03 | Leibinger Medizintech | Knochendistraktor |
DE50104381D1 (de) * | 2001-03-29 | 2004-12-09 | Ct Pulse Orthopedics Ltd | Spreizvorrichtung für Kniegelenke |
WO2003024344A1 (en) * | 2001-09-14 | 2003-03-27 | The Regents Of The University Of California | System and method for fusing spinal vertebrae |
US20040116930A1 (en) * | 2002-06-10 | 2004-06-17 | O'driscoll Shawn W. | Bone plates |
DE20304365U1 (de) * | 2003-03-12 | 2004-07-22 | Dr. Ihde Dental Ag | Knochen- und Weichteildistraktor |
EP1682196A2 (de) * | 2003-11-10 | 2006-07-26 | Angiotech International Ag | Medizinische implantate und anti-narben-mittel |
-
2002
- 2002-03-22 DE DE10212815A patent/DE10212815A1/de not_active Withdrawn
-
2003
- 2003-03-08 AT AT03720150T patent/ATE326179T1/de not_active IP Right Cessation
- 2003-03-08 WO PCT/DE2003/000741 patent/WO2003079912A1/de not_active Application Discontinuation
- 2003-03-08 DK DK03720150T patent/DK1489979T3/da active
- 2003-03-08 CA CA002480261A patent/CA2480261A1/en not_active Abandoned
- 2003-03-08 ES ES03720150T patent/ES2264528T3/es not_active Expired - Lifetime
- 2003-03-08 US US10/508,606 patent/US8092463B2/en not_active Expired - Fee Related
- 2003-03-08 EP EP03720150A patent/EP1489979B1/de not_active Expired - Lifetime
- 2003-03-08 PT PT03720150T patent/PT1489979E/pt unknown
- 2003-03-08 DE DE50303366T patent/DE50303366D1/de not_active Expired - Lifetime
- 2003-03-08 AU AU2003223849A patent/AU2003223849A1/en not_active Abandoned
Patent Citations (4)
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DE19537023A1 (de) * | 1994-10-05 | 1996-04-11 | Medicon Eg Chirurgiemechaniker | Distraktionsvorrichtung |
WO1997020512A1 (en) * | 1995-12-01 | 1997-06-12 | Walker David A | Telescopic bone plate for use in bone lenghtening by distraction osteogenesis |
US5810812A (en) * | 1996-10-16 | 1998-09-22 | Chin; Martin | Apparatus and method for submergible self-retaining mandibular distractor |
WO2000056235A1 (en) * | 1999-03-23 | 2000-09-28 | Synthes Ag Chur | Orthopedic system having detachable bone anchors |
Cited By (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
FR2867965A1 (fr) | 2004-03-23 | 2005-09-30 | Gerard Scortecci | Dispositif de distraction de l'os d'une machoire |
WO2005094717A1 (fr) | 2004-03-23 | 2005-10-13 | Scortecci Gerard | Dispositif de distraction de l’os d’une mâchoire |
US20100241126A1 (en) * | 2006-10-11 | 2010-09-23 | Ignace Ghijselings | Device and method for installing femoral prosthetic knee joint |
US9492186B2 (en) | 2006-10-11 | 2016-11-15 | Ignace Ghijselings | Device and method for installing femoral prosthetic knee joint |
US9498235B2 (en) * | 2006-10-11 | 2016-11-22 | Ignace Ghijselings | Device and method for installing femoral prosthetic knee joint |
US10517615B2 (en) | 2006-10-11 | 2019-12-31 | Ignace Ghijselings | Device and method for installing femoral prosthetic knee joint |
WO2015185601A1 (de) * | 2014-06-04 | 2015-12-10 | Celgen Ag | Distraktionsimplantat mit distanzstegen |
Also Published As
Publication number | Publication date |
---|---|
EP1489979A1 (de) | 2004-12-29 |
ATE326179T1 (de) | 2006-06-15 |
EP1489979B1 (de) | 2006-05-17 |
CA2480261A1 (en) | 2003-10-02 |
US8092463B2 (en) | 2012-01-10 |
PT1489979E (pt) | 2006-09-29 |
US20060058785A1 (en) | 2006-03-16 |
AU2003223849A1 (en) | 2003-10-08 |
DE50303366D1 (de) | 2006-06-22 |
DE10212815A1 (de) | 2003-10-02 |
DK1489979T3 (da) | 2006-10-23 |
ES2264528T3 (es) | 2007-01-01 |
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