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RESUMEN Objetivo: El propósito del presente estudio fue investigar biomecánicamente si el tratamiento con micro-osteoperforaciones (Mops) genera diferencias de desplazamiento y de tensiones a nivel óseo cuando se aplica una carga ortodóncica, mediante el uso de análisis de elementos finitos. Material y Método: Un modelo de mandíbula dentada donde se eliminó el segundo premolar fue utilizado para el análisis. Posteriormente, se dividieron en 3 muestras dependiendo de la posición de las Mops: 1) Sin Mops (control); 2) Mops 1 mm adyacentes al primer molar; 3) Mops a 4 mm del molar. Para la simulación, se aplicó una carga estática horizontal de 150 gr (1,5N), simulando un resorte cerrado de Nitinol, tanto a nivel molar en dirección mesial como a nivel interproximal entre canino e incisivo lateral en dirección distal. Resultados: A pesar que se observó una ligera tendencia a aumentar el desplazamiento del molar con la presencia de Mops, no existieron mayores variaciones en relación a las magnitudes de desplazamiento ni tensiones entre los diferentes modelos. Conclusiones: Desde el punto de vista biomecánico no existen diferencias evidentes en los valores de tensiones ni de desplazamiento entre los modelos analizados.
ABSTRACT: Objective: The purpose of the present study was to biomechanically investigate if the treatment with micro-osteoperforations (Mops) generates displacement and tensions differences at bone level when an orthodontic load is applied, through the use of finite element analysis. Material and Method: A toothed jaw model where the second premolar was removed was used for the analysis. Subsequently, they were divided into 3 samples depending on the position of the Mops: 1) Without Mops (control); 2) Mops adjacent 1 mm to the first molar; 3) Mops 4 mm to molar. To simulate a closed Nitinol spring, an horizontal static load of 150 gr (1.5N) was applied, both at molar level in the mesial direction and at interproximal level between the canine and the lateral incisor in the distal direction. Results: Although a slight tendency to increase the displacement of the molar with the presence of Mops was observed, there were no major variations in relation to the magnitudes of displacement or tensions between the different models. Conclusions: From the biomechanical point of view, there are no obvious differences in the values of stresses or displacement between the models analyzed.
Assuntos
Dente MolarRESUMO
@#As a minimally invasive procedure, micro-osteoperforations (MOPs) achieve desired therapeutic effect with minimal surgical intervention. The operation is relatively simple, and the effect of assisted orthodontic treatment is obvious. However, due to the lack of long-term follow-up studies, there is no unified consensus on the long-term stability of the procedure. This article reviews the research status of MOPs, biological and biomechanical mechanisms, clinical applications and limitations. MOPs can shorten orthodontic treatment time and accelerate tooth movement by exerting regional acceleratory phenomena (RAP). At the same time, this procedure will not damage the health of the periodontal tissue, and the postoperative bleeding and postoperative reaction are minor. In addition, the pain and discomfort of patients were relatively mild and acceptable. However, it also has limitations, mainly including the limited time of the RAP effect of MOPs. Although this procedure is a minimally invasive surgery, there is still a risk of treating regional bone defects. At present, it is still necessary to increase the sample size and extend the follow-up time to evaluate the long-term stability of MOPs.
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Objective: To evaluate the effect of minimally invasive surgery on acceleration orthodontic tooth movement by meta-analysis. Methods: All literatures about minimally invasive surgery accelerating tooth moment were searched from the database in general. The literatures were screened according to the correlation and the inclusion criteria, included literatures were analyzed by RevMan 5. 3. Results: 5 articles including 85 patients were included in this review, 4 of which reported that minimally invasive surgery can accelerate orthodontic tooth movement, but 1 reported no statistical difference in alleviating mandibular anterior crowding between minimally invasive surgery acceleration orthodontic group and conventional orthodontic group. Higher tooth movement rate was found with the minimally invasive surgical procedures by a weighted mean difference of 0. 70 mm in 1 month of canine retraction (WMD = 0. 7: 95％ CI(0. 57, 0. 82); P＜ 0. 001) and by a weighted mean difference 1. 31 mm in 2 months (WMD = 1. 31: 95％ CI (0. 69, 1. 92), P＜ 0. 001). No obvious adverse effects were observed in periodontal condition, pain, satisfaction, root resorption and anchorage control. Conclusion: According to current studies, minimally invasive surgery can accelerate single tooth movement, but the evidence is insufficient to prove that the entire orthodontic treatment time can be shortened.