ABSTRACT
La resorción radicular externa generalizada representa un problema a la hora de realizar un tratamiento de ortodoncia, requiere la toma de decisiones que siempre debe estar fundamentada en el diagnóstico llevado a cabo mediante un equipo interdisciplinario. Objetivo: Describir el tratamiento a una paciente con resorción radicular generalizada ante un proceso completo de diagnóstico que debe ser seguido, buscando preservar la estructura dentaria y la inserción conectiva. Caso clínico: Mujer de 14 años de edad, con motivo de consulta: «tengo un diente fuera de lugar¼, con un biótopo dolicofacial, y maloclusión clase II esquelética, clase I molar, clase I canina, discrepancia osteodentaria negativa, perfil convexo, incompetencia labial, incisivo lateral superior cruzado, resorción radicular generalizada, que predomina en incisivos anteriores superiores. El tratamiento fue ortodoncia (con aparatología fija Roth slot 22), extracciones de segundos premolares superiores e inferiores, cierre de espacios acelerado y ajuste oclusal. Resultado: Al finalizar el tratamiento, se logró mejorar la estética, preservación de la inserción conectiva, estructura dental y una oclusión funcional. Conclusiones: Los pacientes con resorción radicular generalizada necesitan ser diagnosticados correctamente, es importante saber que los resultados se limitan a utilizar fuerzas ligeras y controladas, y es de gran utilidad el aprovechamiento del fenómeno de aceleración regional que está dado por las extracciones dentales, cerrando los espacios desde estadios iniciales del tratamiento (AU)
Generalized external root resorption represents a problem when performing orthodontic treatment, it requires making decisions that should always be based on the diagnosis carried out by an interdisciplinary team. Objective: To describe the treatment of a patient with generalized radicular resorption with a complete diagnostic process that must be followed in order to preserve the tooth structure and the connective insertion. Case report: 14-year-old female patient, with reason for consultation: «I have a tooth out of place¼', with a dolichofacial biotype, class II skeletal malocclusion, class I molar, class I dog, negative osseous discrepancy, convex profile, lip incompetence, superior lateral incisor crossed, generalized radicular resorption, which predominates in upper anterior incisors. The treatment was orthodontics (with Roth slot 22 fixed appliances), extractions of upper and lower second premolars, accelerated space closure and occlusal adjustment. Result: At the end of the treatment, aesthetics, preservation of the insertion and dental structure and a functional occlusion were achieved. Conclusions: Patients with generalized root resorption need to be diagnosed correctly, it is important to know that the results are limited to use light and controlled forces and it is very useful to take advantage of the phenomenon of regional acceleration that is given by the dental extractions, closing the spaces from initial stages of treatment (AU)
Subject(s)
Humans , Female , Adolescent , Patient Care Team , Root Resorption/therapy , Tooth Extraction , Orthodontic Appliances, Fixed , Treatment Outcome , Occlusal Adjustment , Orthodontic Space Closure , Malocclusion, Angle Class IIABSTRACT
Objective: To study the clinical effects of minimally invasive corticotomy, Piezocision, as an adjunct to orthodontic treatment for the cases with missing mandibular first molar. Methods: 29 patients without mandibular first molar were devided into 2 groups and treated by orthodontic treatment with Piezocision (group A, n = 14) and routine orthodontic treatment (group B, n = 15) respectively. The movement distance and periodontal status of mandible second molar after force loading were compared between the 2 groups. Results: At 14, 28, 56, 84 days after add force loading, the movement distance of mandible second molar in group A were longer than in group B (P ＜ 0. 05) . 84 days after force loading, there was no significant difference (P＞ 0. 05) about the periodontal indices in group A compared with those before force loading. Bleeding index (BI) and periodontal depth (PD) in group B were increased 84 days after loading (P ＜ 0. 05) . There was no significant (P＞ 0. 05) of periodontal indices between the 2 groups at 84 days after force loading.Conclusion: Piezocision can accelerate orthodontic tooth movement of mandible second molar and can enture the periodontal health.
ABSTRACT
The aim of this case report was to describe an innovative orthodontic treatment method that combined surgical and orthodontic techniques. The novel method was used to achieve a positive result in a case of moderate crowding by employing a computer-guided piezocision procedure followed by the use of clear aligners. A 23-year-old woman had a malocclusion with moderate crowding. Her periodontal indices, oral health-related quality of life (OHRQoL), and treatment time were evaluated. The treatment included interproximal corticotomy cuts extending through the entire thickness of the cortical layer, without a full-thickness flap reflection. This was achieved with a three-dimensionally printed surgical guide using computer-aided design and computer-aided manufacturing. Orthodontic force was applied to the teeth immediately after surgery by using clear appliances for better control of tooth movement. The total treatment time was 8 months. The periodontal indices improved after crowding correction, but the oral health impact profile showed a slight deterioration of OHRQoL during the 3 days following surgery. At the 2-year retention follow-up, the stability of treatment was excellent. The reduction in surgical time and patient discomfort, increased periodontal safety and patient acceptability, and accurate control of orthodontic movement without the risk of losing anchorage may encourage the use of this combined technique in appropriate cases.
Subject(s)
Female , Humans , Young Adult , Computer-Aided Design , Crowding , Follow-Up Studies , Malocclusion , Methods , Operative Time , Oral Health , Periodontal Index , Quality of Life , Tooth , Tooth Movement TechniquesABSTRACT
O desejo de ter um tratamento ortodôntico mais rápido é comum a pacientes e profissionais, e muitos meios para acelerar o movimento dentário têm sido pesquisado em todo o mundo. Um dos recursos mais publicitados, se fundamenta na aplicação de estímulos vibratórios nos dentes para induzir uma resposta biológica mais rápida. Desta forma, este artigo objetivou discutir, através de revisão crítica da literatura atual se há segurança na aplicação deste estímulo na clínica diária.
The desire to have a short-term orthodontic treatment is common to both patients and orthodontists and many ways to accelerate tooth movement has been researched around the world. One of the most publicized ways is based on the application of vibratory stimuli to the teeth to induce faster biological response. The authors conducted a critical review of the current literature aiming to clarify whether is safety in the application of this stimulus in everyday practice.
Subject(s)
Tooth Movement Techniques/trends , Orthodontics, Corrective , Vibration/therapeutic useABSTRACT
Objective:To investigate the effects of corticotomy assisted orthodontic treatment for mild skeletal Class Ⅱ malocclusion. Methods:7 adult patients with mild skeletal Class Ⅱ division 1 malocclusion were included and underwent corticotomy assisted ortho-dontic treatments.3D measurements and analysis of CBCT data before and after treatment were conducted.Results:The average dura-tion of upper anterior teeth retraction was 3.2 months.After treatment,obvious retraction of up incisiors with the retraction of maxillary alveolar bone and the upper lip backward and downward movement were observed.Conclusion:Corticotomy assisted orthodontic treat-ment is effective in the treatment of mild skeletal Class Ⅱ malocclusion by the retraction of uper anterior teeth,alveolarar bone and soft-tissue profile improvement.
ABSTRACT
The orthodontic treatment is, perhaps, in terms of duration, the longest-performed dental procedure. In this fast-paced world any treatment that would consume 1 – 2 years is unwelcome. It is universally accepted that if the duration of the orthodontic treatment is reduced, there will be an increased favorable attitude towards the orthodontic therapy. To accelerate the tooth movement the orthodontists and the periodontists together have worked out a success formula which is termed Periodontally Accelerated Osteogenic Orthodontics (PAOO) or wilckodontics. Theoretically this procedure is based on the healing property of bone known as (RAP) regional acceleratory phenomenon. This procedure involves the surgical demineralization of the cortical bone (corticotomy) thereby decreasing the resistance offered by the cortical bone of the teeth to the orthodontic force applied and use of particulate bone grafting. This method not only enhances the width of the alveolar bone but also decreases the duration of the treatment and chances of apical root resoption. It also increases the stability of the treatment by reducing the chances of relapse. A proper case selection, careful surgical procedure and accurate orthodontic movements are important for the success of wilckodontics. This review article includes history, biomechanics, indication, contraindication, case selection, treatment planning, surgical techniques and its modifications.
ABSTRACT
El objetivo de este estudio fue comparar clínicamente la velocidad del movimiento ortodóncico y cambios en los parámetros periodontales en pacientes con ortodoncia convencional y ortodoncia facilitada con corticotomía para el tratamiento de apiñamiento dental anterior. Un total de 10 pacientes participaron en el estudio de la siguiente forma: 5 pacientes grupo ortodoncia y corticotomía (EXP) y 5 pacientes grupo ortodoncia (CONT). Se realizó examen clínico completo que incluyó análisis radiográfico, periodontal y modelos de estudio. Las mediciones sobre los cambios periodontal, tabla ósea bucal, movimiento lineal y angular fueron medidos al inicio, 30, 90 y 210 días posterior a los procedimientos. Las diferencias entre los grupos fueron establecidas con la prueba t-Student para muestras pareadas y no pareadas dependiendo del caso. Los dientes sometidos a ortodoncia y corticotomía mostraron una mayor velocidad del movimiento en comparación con el grupo control durante los primero 30 días de examinación (P<0,05). No hubo diferencias estadísticamente significativas en los parámetros clínicos periodontales y grosor de la tabla ósea bucal entre los grupos. En conclusión, la corticotomía acelera el movimiento ortodóncico durante los primero 30 días postquirúrgicos con lo cual se puede reducir el tiempo de tratamiento en pacientes con apiñamiento severo. Adicionalmente, los parámetros clínicos periodontales y el volumen de la tabla ósea bucal de los dientes sometidos a corticotomía se mantienen estables después del procedimiento.
The aim of this study was to compare clinically speed orthodontic movement and changes in periodontal parameters in patients with conventional orthodontics and orthodontics with corticotomy for the treatment of anterior dental crowding. A total of 10 patients participated in the study: 5 patients in the orthodontics and corticotomy group (EXP) and 5 in the orthodontics patient group (CONT). Complete clinical examination included radiographic, periodontal and study models analysis was carried out. Measurements on periodontal changes, buccal bone plate, linear and angular movement were measured at baseline at 30, 90 and 210 days after the procedures. Differences between groups were established with the t-Student for paired and unpaired samples depending on the case. Teeth undergoing orthodontic corticotomy showed greater speed of movement compared to the control group during the first 30 days examination (P <0.05). There were no statistically significant differences in periodontal clinical parameters and thickness of the buccal bone plate between the groups. In conclusion, accelerated corticotomy orthodontic movement during the first 30 days postoperative, can reduce the treatment period in patients with severe crowding. Additionally, clinical periodontal parameters and volume of the buccal bone plate teeth undergoing corticotomy remained stable after the procedure.
Subject(s)
Humans , Male , Female , Adult , Young Adult , Osteotomy/methods , Tooth Movement Techniques/methods , Malocclusion/surgery , Pilot ProjectsABSTRACT
INTRODUÇÃO: a busca pelo aumento na eficiência dos tratamentos ortodônticos é uma constante em diversas áreas da Ortodontia atual. A realização de corticotomias alveolares pouco antes da aplicação de forças ortodônticas vem sendo sugerida como uma forma de potencializar a movimentação dentária e, consequentemente, o tratamento ortodôntico como um todo. OBJETIVO: o presente artigo revê a perspectiva histórica dessa abordagem terapêutica, apresenta e ilustra com casos clínicos suas principais indicações e, por fim, discute os fundamentos biológicos que justificam sua utilização.
INTRODUCTION: The systematic search for increased efficiency in orthodontic treatment is shared by several areas of orthodontics. Performing alveolar corticotomies shortly before the application of orthodontic forces has been suggested as a method to enhance tooth movement and, consequently, orthodontic treatment as a whole. OBJECTIVE: This article reviews the historical perspective of this therapeutic approach, presents and illustrates with clinical cases its main indications and finally discusses the biological reasons underlying its use.