Morphologic evaluation of dentoalveolar structures of mandibular anterior teeth during augmented corticotomy-assisted decompensation.

INTRODUCTION: Our aim in this study was to evaluate the effect of augmented corticotomy on the decompensation pattern of mandibular anterior teeth, alveolar bone, and surrounding periodontal tissues during presurgical orthodontic treatment. METHODS: Thirty skeletal Class III adult patients were divided into 2 groups according to the application of augmented corticotomy labial to the anterior mandibular roots: experimental group (with augmented corticotomy, n = 15) and control group (without augmented corticotomy, n = 15). Lateral cephalograms and cone-beam computed tomography images were taken before orthodontic treatment and before surgery. The measurements included the inclination and position of the mandibular incisors, labial alveolar bone area, vertical alveolar bone height, root length, and alveolar bone thickness at 3 levels surrounding the mandibular central incisors, lateral incisors, and canines. RESULTS: The mandibular incisors were significantly proclined in both groups (P <0.001); however, the labial movement of the incisor tip was greater in the experimental group (P <0.05). Significant vertical alveolar bone loss was observed only in the control group (P <0.001). The middle and lower alveolar thicknesses and labial alveolar bone area increased in the experimental group. In the control group, the upper and middle alveolar thicknesses and labial alveolar bone area decreased significantly. There were no significant differences in dentoalveolar changes between the 3 kinds of anterior teeth in each group, except for root length in the experimental group (P <0.05). CONCLUSIONS: Augmented corticotomy provided a favorable decompensation pattern of the mandibular incisors, preserving the periodontal structures surrounding the mandibular anterior teeth for skeletal Class III patients.

Correction of facial asymmetry and maxillary canting with corticotomy and 1-jaw orthognathic surgery.

Although 2-jaw orthognathic surgery is a typical recommendation for the treatment of facial asymmetry, another good treatment alternative is maxillary corticotomy with temporary skeletal anchorage devices followed by mandibular orthognathic surgery. The corticotomy procedure described here can achieve unilateral molar intrusion and occlusal plane canting correction with potentially fewer complications than 2-jaw orthognathic surgery. The approach allows movement of dentoalveolar segments in less time than with conventional dental intrusion using temporary skeletal anchorage devices. A 2-jaw asymmetry with occlusal plane canting might be corrected using maxillary corticotomy and mandibular orthognathics rather than 2-jaw orthognathics. Two patients with facial asymmetry are presented here. In each one, the maxillary cant was corrected over a period of 2 to 3 months with 3.5 mm of intrusion of the unilateral buccal segment. After the preorthognathic cant correction, orthognathic surgery was done to correct the mandibular asymmetry.