Factors Affecting Predictability of Buccal Bone Augmentation in Surgically Facilitated Orthodontic Treatment: Etiological Considerations.

Pre-orthodontic surgical techniques such as surgically facilitated orthodontic treatment (SFOT) are intended to increase bone volume while reducing the incidence of induced gingival recession. SFOT aims to enhance and thicken the periodontal biotype, including both hard and soft tissue, and facilitate accelerated tooth movement through the induction of the regional acceleratory phenomenon. This article reviews different variables and critical etiological factors that may affect the predictability of generating buccal bone during SFOT and should be diagnosed and addressed prior to combined surgical-orthodontic treatment. In addition, optional modifications to enhance regenerative outcomes of SFOT will be discussed.

Enhancing Periodontal Regenerative Outcomes With Simultaneous Orthodontic Tooth Movement.

Periodontal regeneration of lost tissue, including periodontal ligament (PDL), cementum, and bone, has evolved with regard to surgical techniques, biomaterials, and growth factors. Simultaneous orthodontic therapy and periodontal surgical treatment has been documented previously and shown to enhance the regenerative outcome due to stimulation of the PDL by tooth movement. This combined strategy is becoming increasingly common as clinicians explore the capabilities of a collaborative approach. This article presents a case series that documents three cases in which combined orthodontic and surgical procedures were used to enhance the regenerative outcome in challenging clinical scenarios. The article includes a review of the literature and discusses clinical factors related to increasing predictability in such cases.

Dental Space Deficiency Syndrome: An Anthropological Perspective.

A new syndrome in dentistry, the dental space deficiency syndrome is proposed in this article. Signs and symptoms of this entity may include one or more of the following clinical dental features: tooth crowding, gingival recession, tooth impactions, rapid resorption of facial alveolar bony plates following premature tooth loss, dentally oriented sleep disorders, extended orthodontic treatment time, and malocclusion relapse following orthodontic therapy. These oral conditions, individually or collectively, seem to be associated with both genetic and functional factors. From an anthropological-functional perspective, the human jaws (basal bone and/or alveolar bone) have been shrinking. This results in a three-dimensional discrepancy between jawbone and tooth volumes, which are genetically determined. Consequently, the reduced volume of alveolar bone is not adequately able to accommodate the associated genetically determined dentition in functional and esthetic harmony. This paper describes the common etiology for the conditions listed above, namely the discrepancy between alveolar bone volume (essentially determined by functionality), and associated tooth volume (essentially determined by genetics), when considered in a three-dimensional perspective.