Intrusión acelerada con miniimplantes y corticotomía para crear espacio protésico para implante

La ausencia de un diente puede originar sobre-erupción de su antagonista debido al movimiento fisiológico. Distintos métodos se han empleado para lograr la rehabilitación en espacios interoclusales reducidos, la mayoría implica un tallado del diente antagonista o incluso la extracción dental. La intrusión dental periodontalmente asistida (corticotomía), es una alternativa terapéutica en la que el tallado del diente extruido ya no es necesario, conservando su integridad coronaria. Reporte de caso: Paciente femenino de 56 años con ausencia del 4.7, además presenta sobre-erupción del 1.7, limitando el espacio interoclusal y su rehabilitación. Se realizó intrusión del 1.7 mediante corticotomía con el Piezoeléctrico (técnica Piezocision) así como la colocación de minitornillos de ortodoncia para anclaje. Obtenido dicho espacio interoclusal, se rehabilitó con un implante dental. Conclusiones: La intrusión de molares con el apoyo de mini-implantes y corticotomías es un procedimiento que tiene como beneficio la creación de un espacio interoclusal para su restauración en un periodo corto de tiempo, sin tallar la estructura dentaria.

The absence of a tooth can cause over-eruption of its antagonist due to a physiological movement. Different methods have been used to achieve rehabilitation in reduced interocclusal spaces. Most of them involve the wear of the opposing tooth or even dental extraction. Periodontal-assisted dental intrusion is a therapeutic alternative that does not require the reduction of the extruded tooth and preserves its structure. Case report: 56-year-old female patient with absence of tooth 4.7, also presenting an over-eruption of 1.7, limiting the interocclusal space and rehabilitation. Intrusion of tooth 1.7 was performed with corticotomy using the piezocision technique and placement of mini-screws followed by the placement of a dental implant. Conclusions: The intrusion of molars aided by orthodontic mini-screws and piezocision technique is an effective treatment, whose benefit is the creation of an ideal prosthetic space in a short period of time, avoiding the reduction of dental structure.

Intervenciones quirúrgicas mínimamente invasivas complementarias a la ortodoncia quirúrgicamente asistida: Resumen estructurado de evidencia

Introducción: Existen procedimientos quirúrgicos que pueden generar una disminución en la duración de los tratamientos de ortodoncia (TO) mediante una aceleración del movimiento dental. La técnica más estudiada corresponde a la corticotomía clásica, la cual muchas veces es desechada por los pacientes debido a su invasividad. Es por esto que nacen las intervenciones quirúrgicas mínimamente invasivas (IQMI), tales como las micro osteoperforaciones (MOP) y la piezocisión, que buscan el mismo resultado, pero sin realizar colgajos de espesor total, otorgándole al paciente nuevas alternativas terapéuticas para acortar el tratamiento de ortodoncia. La evidencia al respecto aún es controversial, debido a que la certeza de la evidencia es baja o muy baja con relación a estos procedimientos. Métodos: Realizamos una búsqueda en Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante el cribado de múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, analizamos los datos de los estudios primarios, realizamos un metaanálisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE. Resultados y conclusiones: Identificamos 39 revisiones sistemáticas que en conjunto incluyeron 43 estudios primarios, de los cuales, 31 corresponden a ensayos aleatorizados. Concluimos que las intervenciones quirúrgicas mínimamente invasivas podrían aumentar la tasa de movimiento dental a las 12 semanas, la distancia total acumulada, la tasa de movimiento dental y reducir la duración total de tratamiento, pero la certeza de la evidencia es incierta. Además, podrían resultar en poca o ninguna diferencia sobre el índice gingival, la profundidad de sondaje y el índice de placa.

Introduction: There are surgical procedures that can generate a decrease in the orthodontic (OT) treatments duration through a Acceleration of tooth movement. The most studied technique corresponds to classical corticotomy, which is often discarded by patients due to its invasiveness. This is why minimally invasive surgical interventions (MISI) are born, such as micro osteoperforations (MOP) and piezocision, which seek the same result, but without making total thickness flaps, giving the patient new therapeutic alternatives to shorten orthodontic treatment. The evidence on this is still controversial, because the certainty of the evidence is low or very low in relation to these procedures. Methods: A search was performed using Epistemonikos, the biggest database for systematic reviews in health, which is maintained by screening of multiple sources of information, including MEDLINE, EMBASE, Cochrane, among others. Data from systematic reviews were extracted, and analysis of the primary studies was performed, including a meta-analysis and a summary of findings table using GRADE approach. Results and conclusions: We identified 39 systematic reviews that together included 43 primary studies, of which 31 correspond to randomized clinical trials. We conclude that minimally invasive surgical interventions could increase the rate of tooth movement at 12 weeks, distance total accumulated, the rate of tooth movement and reduce the total duration of treatment, but the certainty of the evidence is uncertain. In addition, they could result in little or no difference in gingival index, probing depth and plaque index.

Influencia del uso de injertos óseos asociados a corticotomía. Revisión Sistemática

Introducción: La corticotomía corresponde a un procedimiento quirúrgico, basado en el Fenómeno de Aceleración Regional (RAP), que tiene por objetivo disminuir hasta en un tercio el tiempo del tratamiento ortodóncico. Esta técnica se puede ejecutar agregando un injerto óseo que aumenta el grosor alveolar, lo que se conoce como Ortodoncia Osteogénica Acelerada Periodontalmente (PAOO) permitiendo un movimiento más amplio y rápido. Objetivo: Determinar la condición final del tejido óseo vestibular en pacientes tratados con corticotomía que recibieron injerto óseo versus pacientes que no recibieron. Materiales y métodos: Se realiza una búsqueda electrónica en la Biblioteca Nacional de Medicina PUBMED bajo la estrategia: "orthodontics" OR "orthodontic treatment" and "osteotomy" OR "corticotomy" OR "periodontally accelerated" and "bone graft" OR "bone grafting" OR "augmented corticotomy" AND "tooth movement". Se realizó el análisis de riesgo de sesgo con la herramienta ROBINS-I. Resultados: La búsqueda arrojo un total de 92 artículos de los cuales 4 fueron elegidos para el análisis Conclusión: Existe una cantidad limitada de estudios sobre el tema, presentando riesgo de sesgo de moderado a alto. Considerando esto, la evidencia indica que la utilización de injerto óseo y membrana contribuye a mejorar las condiciones anatómicas, especialmente si esta última se utiliza fijada.

Introduction: Corticotomy is a surgical procedure based on the Regional Acceleratory Phenomenon (RAP), whose objective is to reduce up to a third the time of orthodontic treatment. This technique can be performed adding a bone graft for the augmentation of the alveolar width and allowing a broader movement. This is known as Periodontally accelerated osteogenic orthodontics (PAOO). Objective: To determine the final condition of the buccal bone tissue after treatment in patients who received corticotomy and bone graft versus corticotomy alone. Materials and methods: An electronic search in the National Library of Medicine PUBMED was performed utilizing the following strategy: "orthodontics" OR "orthodontic treatment" and "osteotomy" OR "corticotomy" OR "periodontally accelerated" and "bone graft" OR "bone grafting" OR "augmented corticotomy" AND "tooth movement". Risk of bias analysis was done utilizing the ROBINS-I tool. Results: The search yielded a total of 92 articles, of which 4 were considered for analysis. Conclusion: There is a limited number of studies regarding this topic and their risk of bias is moderate to high. Thus, the available evidence suggests that the use of bone graft and a resorbable membrane contributes to the improvement of the anatomical conditions, especially if the latter is fixed.

Effect of corticotomy techniques accelerating orthodontic tooth movement on root resorption / 北京大学学报(医学版)

In recent years, developing new methods to accelerate orthodontic tooth movement (OTM) has attracted extensive attention in the field of orthodontic clinical and scientific research. It reduces orthodontic treatment time and risks. Over the past, various approaches have been done to accelerate orthodontic tooth movement. Several forms of corticotomy techniques have been effective in inducing rapid tooth movement. These techniques activate regional acceleratory phenomenon and create a favorable microenvironment for accelerating tooth movement. Root resorption is one of most common side effects of orthodontic treatment. It affects the long-term viability and health of teeth. However, the effect of corticotomy techniques accelerating orthodontic tooth movement on root resorption still remains unclear. Accelerating tooth movement may have two-side effects on root resorption. Through shortening the treatment period and removing the hyalinized tissues, the acceleration of orthodontic tooth movement could reduce root resorption. The increase of root resorption might be due to the local inflammation and function of cementoclasts/odontoclasts. In this paper, we reviewed the effects of different corticotomy techniques accelerating orthodontic tooth movement on root resorption. Corticotomy techniques deal with mucoperio-steal flaps and bone tissues differently and develop towards minimally invasive. Previous studies on root resorption use two-dimensional images, including apical films and panoramic tomography, to evaluate the degree of root resorption. In recent years, researches measure the volume of root resorption accurately using cone-beam computed tomography (CBCT) and micro-CT. Most studies suggest that the root resorption during acceleration of orthodontic tooth movement through corticotomy techniques is not statistically different from that of traditional orthodontic treatment. Some studies using micro-CT have shown that the root resorption in the groups of corticotomy techniques increases compared with the control group without surgery. Because of the short duration of these studies, the clinical significance is controversial on the overall impact of corticotomy techniques on orthodontic treatment. Accelerating orthodontic tooth movement is still at its emerging phase and need further research in the form of clinical trials to illustrate the effect of corticotomy techniques accelerating orthodontic tooth movement on root resorption.

Digital evaluation of supracrestal gingival thickness induced by periodontal regenerative and corticotomy surgery in patients with skeletal class Ⅲ malocclusion / 中华口腔医学杂志

Objective@#To establish a quantitative three-dimensional method based on intraoral scan to evaluate the changes of soft tissue, and to evaluate the changes of supracrestal gingival thickness (SGT) in skeletal class Ⅲ patients induced by periodontal regenerative and corticotomy surgery (PRCS).@*Methods@#Twenty-two systematically and periodontally healthy skeletal class Ⅲ patients (4 males and 18 females, aged between 19 and 35 years), who were in need of combined orthodontic-orthognathic treatment and referred to the Department of Periodontology from the Department of Orthodontics and the Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology from January, 2018 to March, 2019, were collected in the study. The teeth involved were 112 anterior teeth (46 maxillary anterior teeth and 66 mandibular anterior teeth). PRCS in anterior tooth area was conducted before orthodontic decompensation. Probing depth (PD), bleeding index (BI) and keratinized gingiva width (KGW) were recorded before surgery and 6 months post-surgery. The intraoral digital impressions of maxillary and mandibular anterior teeth were obtained by 3-shape intraoral scanner before surgery and 6 months after surgery. The Standard Tessellation Language (STL) files were processed using Geomagic qualify 12.2 software to establish the soft tissue morphological measurement model, and to quantitatively analyze the changes of gingival thickness situated 1 to 2 mm apical to the free gingival margin on the median sagittal measurement plane.@*Results@#Probing depth and bleeding index had no significant difference before and 6 months after operation (P>0.05). KGW in 6-month post-operation group [(5.18±2.32) mm] was significantly higher than that in pre-operation group [(4.22±1.43) mm] (P<0.05). Supracrestal gingival thickness situated 1 to 2 mm apical to the free gingival margin also significantly increased 6 months after surgery (P<0.05). The changes of gingival thickness situated 1 to 2 mm apical to the free gingival margin in the upper anterior area were (0.68±0.56) and (1.00±0.69) mm, respectively. The changes in the lower anterior area were (0.38±0.42) and (0.58±0.45) mm, respectively. The gingival changes of the upper anterior teeth were also significantly higher than those of the lower anterior teeth (P<0.01).@*Conclusions@#The described quantitative measurement based on intraoral scan could be an effective method for quantitative evaluation of the changes of soft tissue. PRCS could safely increase the supracrestal gingival thickness as well as KGW in skeletal class Ⅲ patients who were in need of combined orthodontic-orthognathic treatment.

Effect of two corticotomy protocols on periodontal tissue and orthodontic movement

Abstract Objective To compare two corticotomy surgical protocols in rats to verify whether they alter conventional orthodontic movement. Methodology Sixty Wistar rats were divided into three groups - orthodontic movement (CG), orthodontic movement and corticotomy (G1) and orthodontic movement with corticotomy and decortication (G2) - and euthanized after 7 and 14 days. Tooth movement (mm), bone volume fraction and bone volume ratio to total volume (BV/TV), and bone mineral density (BMD) were evaluated by micro-CT. The total amount of bone was measured in square millimeters and expressed as the percentage of bone area in the histomorphometry. The number of positive TRAP cells and RANK/RANKL/OPG interaction were also investigated. Results Day 14 showed a statistically significant difference in orthodontic tooth movement in CG compared with G1 (7.52 mm; p=0.009) and G2 (7.36 mm; p=0.016). A micro-CT analysis revealed a difference between CG, G1 and G2 regarding BV/TV, with G1 and G2 presenting a lower BV/TV ratio at 14 days (0.77 and 0.73 respectively); we found no statistically significant differences regarding BMD. There was a difference in the total amount of bone in the CG group between 7 and 14 days. At 14 days, CG presented a significantly higher bone percentage than G1 and G2. Regarding TRAP, G2 had more positive cells at 7 and 14 days compared with CG and G1. Conclusion Corticotomy accelerates orthodontic movement. Decortication does not improve corticotomy efficiency.

Clinical study of accelerating orthodontic space closure for missed mandible first molar by Piezocision / 实用口腔医学杂志

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.

Chronic recurrent multifocal osteomyelitis in a 9 year old girl: A Case Report

Background and Objectives: Chronic recurrent mutlifocal osteomyelitis (CRMO) is an extremely rare skeletal disorder in the younger population. It presents with multifocal bony lesions that often mimic more sinister diagnoses such as neoplasm. The cause of this condition remains unknown and there is limited evidence on effective treatment.Presentation of Case: A 9-year-old girl presented to our institution with non-traumatic onset of left leg pain. After failed conservative management, radiographs and MRI were obtained exhibiting a bony lesion of the proximal tibia resembling osteomyelitis. The patient was non-responsive to antibiotics, so corticotomy and drainage was done in which only blood came out of the lesion, no pus was seen. Patient improved dramatically but again she developed similar symptoms and signs on right leg. Biopsy from left leg suggested no significant findings.Discussion: Chronic recurrent multifocal osteomyelitis presents in patients with periodic fevers, bone pain and bone lesions that can develop anywhere in the body. This is a rare disease, which has been found to affect more girls than boys.Conclusion: CRMO should be considered as a differential diagnosis for chronic bone pain with affinity for the long bones of the lower extremity in children and adolescents.

Finite Element Analysis on Corticotomy-facilitated Orthodontic Tooth Movement in Rat / 医用生物力学

Objective To simulate the orthodontic tooth movement (OTM) after corticotomy in rat and analyze its effects on mechanical distribution in dentoalveolar structures.Methods 3D finite element model of corticotomy-facilitated OTM in rat was established and the circumscribing corticotomy approach was simulated. The periodontal ligament (PDL) and alveolar bone around the mesial root were partitioned according to direction of the orthodontic load and corresponding part of the root. The initial displacement of the first molar and segmented alveolar bone as well as the stress and strain in PDL and alveolar bone were calculated. Results The first molar presented a tipping movement and the distal cusp showed the maximum displacement. Corticotomy could increase the relative displacement of bone segment. The maximum principal strain in PDL concentrated on the mesial and distal cervical region, while the minimum principal strain concentrated on the distal apical region. Corticotomy could change the distribution and magnitude of the maximum and minimum principal strain in PDL and Von Mises stress in alveolar bone. Conclusions Corticotomy can affect the mechanical distribution of orthodontic force in tooth and periodontal tissues around, and hence facilitate regional bone remodeling to realize rapid OTM. The research findings contribute to understanding the mechanism of corticotomy to facilitate OTM from the aspect of biomechanics.

Clinical advances in corticotomy-assisted orthodontic treatments / 口腔疾病防治

@#Recently, corticotomy-assisted orthodontic treatments have gathered increasing clinical attention and have been applied more frequently. This technique evolved from traditional corticotomies on the buccal and palatal sides to buccal flapless corticotomies. Accumulating clinical studies suggest that this method leads to accelerated tooth movement, augmented alveolar bone and improved periodontal tissue health. This paper provides an overview of the development of this surgical technique and clinical research results.

Comparison of clinical and histological characteristics of orthodontic tooth movement into recent and healed extraction sites combined with corticotomy in rats / 대한치과교정학회지

OBJECTIVE: This study was performed to investigate the rate of tooth movement and histological characteristics of extraction sockets those were subjected to corticotomy. METHODS: A split-mouth randomized controlled trial experiment was designed. Thirty-two adult, male Wistar rats were divided into 2 groups: healing extraction socket (H) and recent extraction socket (R); these groups were randomly classified into 4 subgroups (0/7/21/60 days). The first maxillary molar was extracted on 1 side and 2 months were allowed for complete bone healing; then, the corresponding molar was extracted on the other side and surgical intervention was performed at the mid-alveolar point of the first maxillary molar. Ten grams of continuous force was applied. The outcomes measured were rate of tooth movement, percentage of periodontal space and histological evaluation. The rate of tooth movement was calculated as the measured distance divided by the duration of molar movement. Histomorphometric evaluations were performed on the second and third maxillary molars. The Wilcoxon signed rank test was used to compare differences between the two groups. RESULTS: There were no significant differences in the rates of tooth movement between H and R groups at any of the 4 time points. The histological appearance and percentage of periodontal space between the R and H groups also demonstrated no significant differences. CONCLUSIONS: The rates of orthodontic tooth movement into recent and healed socket sites did not differ between the groups. Histological analysis of tooth movement revealed regional acceleration during every time period.

Adjunctive buccal and palatal corticotomy for adult maxillary expansion in an animal model / 대한치과교정학회지

OBJECTIVE: This study aimed to explore the usefulness of adjunctive buccal and palatal corticotomy for adult maxillary expansion in an animal model using cone-beam computed tomography (CBCT). METHODS: Twelve adult sheep were randomly divided into two groups (each n = 6): a control group, where no treatment was administered, and a treatment group, where buccal and palatal corticotomy-assisted maxillary expansion was performed. CBCT scans were taken before (T1) and after (T2) treatment. Differences in all transverse dental and alveolar dimensions, alveolar width at crest level, hard palate level, horizontal bone loss, interdental cusp width and inter-root apex were assessed using Wilcoxon signed-rank and Mann-Whitney U-tests. Kruskal-Wallis tests and pairwise comparisons were used to detect the significance of differences among the inter-premolar and inter-molar widths. RESULTS: CBCT data revealed significant changes in all transverse dental and alveolar dimensions. The mean interpremolar alveolar width showed an increase of 2.29 to 3.62 mm at the hard palate level, 3.89 to 4.38 mm at the alveolar crest level, and 9.17 to 10.42 mm at the buccal cusp level. Dental changes in the vertical dimension were not significant. CONCLUSIONS: Our findings based on an adult animal model suggest that adjunctive buccal and palatal corticotomy can allow for both skeletal and dental expansion, with the amount of dental expansion exceeding that of skeletal expansion at alveolar crest and hard palate levels by two and three folds, respectively. Therefore, this treatment modality is potential to enhance the outcomes of maxillary expansion in adults.

The effectiveness of corticotomy and piezocision on canine retraction: A systematic review / 대한치과교정학회지

The aim of this systematic review was to evaluate the effectiveness and complications of corticotomy and piezocision in canine retraction. Five electronic databases (PubMed, SCOPUS, Web of Science, Embase, and CENTRAL) were searched for articles published up to July 2017. The databases were searched for randomized control trials (RCTs), with a split-mouth design, using either corticotomy or piezocision. The primary outcome reported for canine retraction was either the amount of tooth movement, rate of tooth movement, or treatment time. The secondary outcome was complications. The selection process was based on the PRISMA guidelines. A risk of bias assessment was also performed. Our search retrieved 530 abstracts. However, only five RCTs were finally included. Corticotomy showed a more significant (i.e., 2 to 4 times faster) increase in the rate of tooth movement than did the conventional method. For piezocision, both accumulative tooth movement and rate of tooth movement were twice faster than those of the conventional method. Corticotomy (with a flap design avoiding marginal bone incision) or flapless piezocision procedures were not detrimental to periodontal health. Nevertheless, piezocision resulted in higher levels of patient satisfaction. The main limitation of this study was the limited number of primary research publications on both techniques. For canine retraction into the immediate premolar extraction site, the rate of canine movement after piezocision was almost comparable to that of corticotomy with only buccal flap elevation.

Corticotomy for orthodontic tooth movement

Corticotomy was introduced as a surgical procedure to shorten orthodontic treatment time. Corticotomy removes the cortical bone that strongly resists orthodontic force in the jaw and keeps the marrow bone to maintain blood circulation and continuity of bone tissues to reduce risk of necrosis and facilitate tooth movement. In the 21st century, the concept of regional acceleratory phenomenon was introduced and the development of the skeletal anchorage system using screw and plate enabled application of orthopedic force beyond conventional orthodontic force, so corticotomy has been applied to more cases. Also, various modified methods of minimally invasive techniques have been introduced to reduce the patient's discomfort due to surgical intervention and complications after surgery. We will review the history of corticotomy, its mechanism of action, and various modified procedures and indications.

Advances in surgical techniques of periodontal corticotomy / 华西口腔医学杂志

The number of adults seeking orthodontic treatment is increasing. Shortening the course of orthodontic treatment has become a research hotspot in recent years. Methods of accelerating tooth movement have been reported. Theoretical and clinical studies have confirmed that periodontal corticotomy is effective in accelerating tooth movement and increasing osteogenic potential. Many surgical techniques of periodontal corticotomy have been developed. This review summarizes the history of periodontal corticotomy and the development of the surgical techniques in recent years, thereby providing references for the clinical application of corticotomy.

Corticotomy assisted orthodontic treatment A boom to adult orthodontics

Corticotomy assisted orthodontic treatment is a time-honored and effective orthodontic procedure that progressively extended admiration as an adjunct treatment preference for adults. It involves selective alveolar decortication in the form of lines and dots performed around the tooth that are to be moved. It is done to induce a state of increased tissue turnover and a transient osteopenia, which is followed by a faster rate of orthodontic tooth movement. The treatment time is reduced to one-third of that in conventional orthodontics. Its main advantages are reduction of treatment time and post orthodontic stability. The aim of this article is to present a broad review on the corticotomy assisted orthodontic treatment in adults.

Selective alveolar corticotomy to intrude overerupted maxillary first molars: analysis of pulp vitality / Corticotomía alveolar selectiva para la intrusión de los primeros molares superiores extruidos: análisis de la vitalidad pulpar

The excessive and prolonged orthodontic treatment might result in loss of pulp vitality. Selective alveolar corticotomy is an alternative to accelerate the orthodontic treatment in adults. This study aimed to evaluate the impact of selective alveolar corticotomy associated with orthodontic intrusion on pulp vitality of overerupted maxillary first molars. Six individuals with extruded maxillary first molars were randomly selected to undergo corticotomy as coadjuvant therapy for intrusion. Pulp vitality was evaluated with thermal (Endo-Ice and Heated gutta-percha) and electric tests before the surgical procedure and after intrusion (90 days). The intrusion of all teeth was obtained (mean 2.26 ± 0.52 mm), and all teeth responded positively to pulp vitality tests before and after intrusion. This suggests that selective alveolar corticotomy did not promote pulp damage, and can be considered an effective and safe auxiliary method to intrusion of overerupted maxillary molars.

El tratamiento de ortodoncia prolongado puede provocar la pérdida de la vitalidad pulpar. La corticotomía alveolar selectiva es una alternativa para acelerar el tratamiento de ortodoncia en adultos. El objetivo del presente estudio fue evaluar el impacto de corticotomía alveolar selectiva asociada a la intrusión dental con ortodoncia en la vitalidad pulpar de los primeros molares superiores extruidos. Seis individuos con primeros molares superiores extruidos fueron seleccionados al azar para someterse a corticotomía como terapia adyuvante para la intrusión dental. La vitalidad pulpar se evaluó en ensayos térmicos (Endo-ice y gutapercha climatizada) y eléctrica antes del procedimiento quirúrgico y después de la intrusión (90 días). Se obtuvo la intrusión de todos los dientes (media 2,26 ± 0,52 mm) y todos los primeros molares respondieron positivamente a las pruebas de vitalidad pulpar, antes y después de la intrusión. Los resultados sugieren que la corticotomía alveolar selectiva no promueve daño pulpar y se puede considerar un método eficaz y seguro para ayudar a la intrusión de molares extruidos.

Evaluation on efficacy of corticotomy-facilitated treatment in skeletal class Ⅱ patients / 中华口腔医学杂志

Objective@#To investigate the effect of corticotomy-facilitated orthodontics on the treatment time and final outcome in skeletal class Ⅱ division 1 patients.@*Methods@#Twenty adult skeletal class Ⅱ division 1 patients treated with two maxillary first premolar extractions were included and randomly divided into two groups (the corticotomy group and the control group). The treatment time was recorded and the changes of soft and hard tissue were compared by using three-dimensional measurement and analysis of cone-beam CT images before and after treatment.@*Results@#There was no significant difference in the alignment time between two groups, while the time of maxillary space closure and the total treatment time in corticotomy group ([5.8±1.3] and [24.9±5.1] months, respectively) were shorter than that in the control group ([9.9±1.1] and [30.8±4.6] months, respectively) and the differences were significant (P<0.01). In the corticotomy group, the retraction amount of the upper central in cisal margin, apical tip, supradentale, labrale superius and the increase of nasolabial angle were greater than those in the control group (P<0.05).@*Conclusions@#In patients with mild to moderate skeletal class Ⅱ division 1 malocclusion, corticotomy-facilitated orthodontics can not only shorten the treatment time, but is more conductive to the retraction of upper anterior teeth and improvement of the profile.

Clinical study of accelerating orthodontic tooth movement by minimally invasive corticotomy / 实用口腔医学杂志

Objective:To evaluate the influence of minimally invasive corticotomy on the treatment time and molar anchorage of adult orthodontic extraction cases.Methods:60 adult cases of Angle Class Ⅰ crowding malocclusion were devided into 3 groups (n =20) and treated by orthodontic treatment wtih minimally invasive corticotomy(group A),orthodontic treatment with classic modified corticotomy(group B) and routine orthodontic treatment (group C) respectively.Time needed for leveling and alignment,space closure,delicate adjustment,total treatment time and mesial sagittal antedisplacement of first molar anchorage were compared among the 3 groups.Results:Time needed for leveling and alignment of orthodontic treatment of group A,B and C was (5.64 ± 2.57),(4.91 ± 3.31) and (8.87 ± 3.75) months respectively(C vs A or B,P ＜ 0.01).Time needed for space closure of group A,B and C was (6.84 ± 2.69),(6.64 ± 3.87) and (8.63 ± 3.29) months respectively(C vs A or B,P ＜0.01).Time needed for delicate adjustment showed no significant difference among the 3 groups(P ＞ 0.05).Total treatment time of group A,B and C was (16.07 ± 6.21),(15.77 ± 5.11)and (21.94 ± 5.74) months respectively (C vs A or B,P ＜ 0.01).There was on statistical difference of mesial sagittal antedisplacement of first molar anchorage among the 3 groups.Conclusion:Minimally invasive corticotomy can shorten the orthodontic treatment time,but can not decrease the retraction resistance of the anterior teeth.

Periodontally Accelerated Osteogenic Orthodontics (PAOO) - An Updated Literature Review and Recent Advances.

Malpositioned teeth are responsible for aesthetic and occlusal aberrations in many adults. Orthodontic movement is considered a “periodontal phenomenon” because all the periodontal tissues are involved in tooth movement. Lengthy orthodontic treatment time has been linked to an increased risk of root resorption, gingival inflammation, decalcification, and dental caries. 2 Therefore, reducing the treatment time is an appropriate goal, which requires increasing the rate of tooth movement. To meet the constant demand to shorten the treatment time and to maintain the integrity of periodontal structures an alternative clinical procedure has been popularized, known as Accelerated Osteogenic Orthodontics (AOO) and, more recently, the Periodontally Accelerated Osteogenic orthodontics. This article over review of literature of this technique and describes recent advances in this procedure.