Authors' response.

Abstract

We appreciate the interest in our study, “Rate of tooth movement and dentoskeletal effects of rapid canine retraction by dentoalveolar distraction osteogenesis: A prospective study” (Am J Orthod Dentofacial Orthop 2017;152:204-13). Our responses to the authors' comments and questions are below. Conventional orthodontic treatment relies on biologic tooth movement and can only be achieved at a limited rate. A technique using transport distraction osteogenesis was designed to reduce orthodontic and orthognathic treatment time. The dentoalveolar distraction (DAD) technique was introduced and used to achieve rapid tooth movement within the principles of distraction osteogenesis.1Kişnişci R. İşeri H. Dentoalveolar transport osteodistraction and canine distalization.J Oral Maxillofac Surg. 2011; 69: 763-770Abstract Full Text Full Text PDF PubMed Scopus (8) Google Scholar Surgical technique is based on tooth extraction, removal of the buccal bone of the extraction socket, and complete horizontal and vertical osteotomies. The transport dentoalveolar segment includes the buccal cortex and the underlying spongious bone-enveloped canine root while leaving an intact lingual or palatal cortical plate. Therefore, the DAD protocol is completely different from conventional biologic orthodontic tooth movement and includes distalization of the canine with its surrounding hard and soft tissues. According to the biologic principles, distraction osteogenesis begins with the development of a reparative callus that generates new bone under tension with gradual traction at the distraction site. Moreover, no gingival recession was observed in any study subject. This observation supported the findings of Gürgan et al,2Gurgan C.A. Iseri H. Kisnisci R. Alterations in gingival dimensions following rapid canine retraction using dentoalveolar distraction osteogenesis.Eur J Orthod. 2005; 27: 324-332Crossref PubMed Scopus (17) Google Scholar who evaluated the alterations in gingival dimensions after rapid canine retraction using DAD at the 1-, 6-, and 12-month follow-up periods compared with pre-DAD. The authors found that the buccal sites showed no significant pocket depth changes, whereas the changes of pocket depth at the mesial and distal sites were insignificant at the 12-month follow-up. This clinical finding indicated that as the canine is moved within the alveolar segment, there will be minimal risk of harmful side effects on the marginal soft tissues and also to the supporting alveolar bone.2Gurgan C.A. Iseri H. Kisnisci R. Alterations in gingival dimensions following rapid canine retraction using dentoalveolar distraction osteogenesis.Eur J Orthod. 2005; 27: 324-332Crossref PubMed Scopus (17) Google Scholar Fixed orthodontic treatment was started immediately after the DAD procedure as mentioned in the “Material and methods” section of our article. The anchorage loss finding is based on the statistical data of 36 canines in the DAD group by making measurements at the start and end of the DAD procedure (11.8 ± 1.3 days). No significant maxillary first molar tipping, vertical displacement, and mesial movement indicating anchorage loss were found in the DAD group (Table IV). It might be misleading to draw conclusions by looking at the intraoral pictures of the patient (Figs 5 and 6). Conventional fixed orthodontic treatment protocol and retention appliances were used for all study subjects. Rapid canine retraction by dentoalveolar distraction osteogenesisAmerican Journal of Orthodontics and Dentofacial OrthopedicsVol. 153Issue 1PreviewWe read the article entitled “Rate of tooth movement and dentoskeletal effects of rapid canine retraction by dentoalveolar distraction osteogenesis: a prospective study” in the August 2017 issue with great interest (Kurt G, İşeri H, Kişnişçi R, Özkaynak O. Am J Orthod Dentofacial Orthop 2017;152:204-13). Full-Text PDF