Complex orthodontic-surgical rehabilitation of adults with malocclusions and deformations in dentition

Abstract

The aim of the study was the development and substantiation of the method of orthodontic treatment of patients with malocclusions and deformities of dentoalveolar arches with the combined use of braces, orthodontic miniscrew, piezo-surgical corticotomy or laser corticotomy to improve the efficiency and reduce the time of complex treatment. The results of complex rehabilitation of 80 adult patients with dentoalveolar anomalies and deformities of dentition are presented. As a result of the orthodontic treatment of patients who underwent piezo-surgical corticotomy the bodily movement of the posterior teeth in the area of the previously removed tooth was achieved. After piezo-surgical or laser corticotomy the rate of tooth protraction remained elevated for 3 to 5 months (on average 0.3±0.5 mm/month), then gradually decreased. Piezo-surgical corticotomy led to a decrease in bone density, which was measured on the Hounsfield scale. As a result of orthodontic treatment in patients who underwent laser corticotomy an expansion of the upper jaw and normalization of occlusion in the transversal and sagittal directions was achieved: in the region of the hard palate by 7.1±0.4 mm; in the region of the alveolar bone by 6.5±0.5 mm; in the region of the roots of molars by 6.4±0.9 mm; in the area of crowns of molars by 8.3±0.7 mm. It was found that the combined use of piezo-surgical corticotomy and orthodontic miniscrews improve the efficiency and reduce the duration of orthodontic treatment by 3 to 6 months.