Presentation of a novel surgical technique in periodontally accelerated osteogenic orthodontics. CBCT assessment of the buccal alveolar dimensional changes: a proof-of-concept report of four cases.

Abstract

The aim of this report was to present the effectiveness of a novel augmented corticotomy performed before orthodontic treatments in the prevention of buccal alveolar dehiscence and gingival recession. Four periodontally healthy individuals presenting crowding and thin bone morphotype in the mandibular anterior area were treated with a double-layer tunnel flap, piezotomy, and hard and soft-tissue augmentation. Patients were divided into two groups according to the utilized graft material. The exclusive use of demineralized bovine bone minerals (group 2) was compared to the use of autologous concentrated growth factor-enriched bone graft matrix, "sticky bone" (group 1). CBCT measurements were performed before and 6 months after surgery. Orthodontic treatment was initialized 1 week after surgery. Postoperative wound healing was uneventful, and tooth alignments were successful in all cases. Postoperative buccal hard tissue dimensions were favorable in both groups, with no occurring bone dehiscence or gingival recession. The seemingly better results of group 2, in terms of quantitative hard tissue changes, did not have any clinical significance according to the objective to be achieved. In contrast, qualitative radiographic analysis showed a more homogenous tissue formation around teeth in group 1. It can be concluded that the presented preorthodontic treatment approach seems to be successful in preventing alveolar dehiscence and gingival recession around buccally inclined mandibular anterior teeth.