Alveolar Corticotomies Research Articles

Laser assisted accelerated orthodontics – a split mouth study

ABSTRACT Aim The aim is to evaluate the impact of LASER on the rate of orthodontic tooth movement. Materials and method The LASER procedure to assist canine distalization was performed on the right maxillary quadrant, and conventional canine distalization in left maxillary quadrant for all patients. Four perforations of diameter 1.5 mm each were made distal to the canine in non-contact mode. Distalization was initiated immediately after the LASER procedure using NiTi closed coil springs of 9 mm length with an approximate force of 150 gm for both sides. In addition to the rate of canine distalization, pain perceived by the patient was also noted after the surgical procedure. Results The mean rate of canine distalization in the LASER side and control side was 1.43 ± 0.11 mm/month and 1.22 ± 0.11 mm/month, respectively. The distribution of the mean rate of canine distalization between the cases considered is significantly higher on the LASER side as matched to the control side. The mean distance travelled on the experimental side was 6.97 ± 0.55 mm, while it was 5.87 ± 0.55 mm on the control side. The distribution of the mean distance travelled by canine between the cases considered is significantly higher on the LASER side as matched to the control side. A significantly higher proportion of cases showed improved pain perception at 24 hrs compared to pain perception at 3 hrs. Conclusion Use of LASER in cases of individual maxillary canine retraction resulted in a higher rate of canine distalization and shorter duration of overall treatment, with no major complications after LASER-assisted alveolar corticotomies.

Use of Lasers and Piezoelectric in Intraoral Surgery.

Laser therapy has been delivering good results for more than 30years. Therapeutic effects are seen due to its ability to stimulate cell proliferation, revascularization, cell regeneration, local microcirculation, and vascular permeability; leading to edema reduction and analgesic effects. The piezoelectric system has been used in several surgeries recently, following the trend of minimally invasive surgery. The system consists of crystals undergoing deformation when exposed to electric current, resulting in an oscillating movement with ultrasound frequency. In oral surgery it is used in orthognathic and temporomandibular joint procedures, alveolar corticotomies, tumor excision, bone grafts, third molars, and dental implants.

Traction of an impacted maxillary canine with corticotomy in a 53-year-old patient: Case report

The viability of orthodontic traction of impacted teeth in adults is often questioned by a large percentage of orthodontists who would rather consider the extraction of these teeth. Although possible, orthodontic traction of impacted canines in adults takes longer than in younger patients, present a poorer prognosis that worsens with age. Because of the prevalence of periodontitis in adults versus children, periodontal inflammation must be identified and resolved in order to keep attachment loss from progressing during orthodontic care. Likewise mucogingival changes need to be predicted and managed. This article reports a successful case of impacted maxillary right canine traction in an adult female, associated with alveolar corticotomies and the use of skeletal anchorage. At the end of treatment, the canine was ideally positioned in the occlusion, presenting excellent esthetics, function, and healthy periodontal tissues.

A systematic analysis of evidence for surgically accelerated orthodontics.

BackgroundCorticotomy is a technique presumed as useful to decrease the time for orthodontic treatment, however, it is necessary to do a systematic review in order to determine if there is enough scientific evidence to back up the use of Corticotomy to accelerate the treatment.Material and MethodsData was stockpiled from the electronic database such as PubMed, Cochrane, Scopus y Science Direct, according to the PRISMA linings for systematic reviews, using the following keywords: accelerated movement of the teeth AND osteotomy AND piezocision AND corticotomy AND orthodontics. Only English, Spanish and French language articles that met the criteria needed were included.ResultsIn the different accelerated orthodontics techniques, a significant reduction in the total time of orthodontic treatment was obtained. There were no major complications reported in any study. The less invasive procedures had better acceptance.DiscussionThe surgical approaches are not only limited to usual orthodontic treatments, but they have also been used as an alternative for the approach of a palatal fistula in a patient with bilateral cleft lip and palatine orofaciodigital syndrome Type I.ConclusionsThere has been a growing interest in the use of alveolar corticotomies as an adjunct to orthodontic treatment, due to a deeper understanding of its effects and a more robust investigation based on the evidence. All published results indicate a decrease in the total treatment time. Key words:Accelerated movement of the teeth, piezocision, corticotomy AND orthodontics.

Using Piezoelectric System in Oral and Maxillofacial Surgery

Motors and handpieces with the piezoelectric system have recently been used in several surgeries, following the current minimally invasive trend surgery. The system consists of crystals or ceramics undergoing deformation when exposed to electrical current, resulting in an oscillating movement with ultrasound frequency. In the Oral and Maxillofacial Surgery field activity, the piezosurgery may be used in maxillary and mandibular osteotomies in the orthognathic surgery, alveolar corticotomies, cysts tumors, facial trauma surgery, among others. This study aims to present a literary review on the piezoelectric system, which allows discussion to their use and effectiveness in oral surgery procedures.

Other interesting effects of alveolar corticotomies in orthodontics apart from the acceleration of tooth movement

The acceleration of orthodontic tooth movement due to alveolar corticotomies has been well documented in the literature. It is defined by a phenomenon of transient osteopenia named “the regional acceleratory phenomenon” by Frost. This biological mechanism has been described in studies on both humans and animals. However, other interesting effects in orthodontics are associated with alveolar corticotomies: higher amplitude of tooth movements, a decrease of the root resorptions and an increase of stability after orthodontic treatment.

Collaboration between periodontics and orthodontics: interest of alveolar corticotomies and piezocision. Review of literature

Orthodontics in adults must adapt to certain particularities especially related to the decrease or absence of growth and the prevalence of periodontal damage in this population. This review of the literature aims to assess the effects of alveolar corticotomies on accelerating or facilitating tooth movements in different types of orthodontic movements, to compare results obtained by classical technique with those obtained by piezocision and analyze their impact on periodontal tissues in the long term. Research was performed with Medline, Embase and Cochrane databases, beginning in January 2000. Every study, selected through its title and abstract, was then evaluated through its full content. A total of 65 studies were included. All studies showed that corticotomies temporarily facilitate accelerated orthodontic tooth movement, with minimal complications. No periodontal lesion, loss of pulpal vitality or severe root resorption were reported. Only a few studies have examined control groups treated with conventional orthodontics. Corticotomy allows temporary acceleration of orthodontic tooth movement. Piezocision is less invasive and performed in certain indications; it also lightens the postoperative complications. However, the fact that using alveolar corticotomies significantly decreases the treatment time remains uncertain, due to the lack of significant data. Further prospective randomized clinical studies are necessary to analyze more precisely the decrease in the overall treatment time, improved periodontal support and stability of orthodontic treatment results in the long term following the alveolar corticotomies.

Effectiveness of selective alveolar decortication in accelerating orthodontic treatment: a systematic review

The number of scientific publications on accelerating orthodontic treatment, and especially surgical alveolar corticotomies techniques, has grown exponentially over the years. The objective of this systematic literature review was to assess the effectiveness of these corticotomies basing on human studies. The review was conducted from Medline and Web of Science Core Collection to identify prospective controlled clinical trials with duration of orthodontic treatment or the tooth movement rate for primary endpoint. Eleven studies respected all inclusion criteria. Six investigated the duration of treatment and found shorter values in experimental group than in control group, with a gain of 8 to 34 weeks. Five investigated the tooth movement rate and found 2.3 times higher values on average during the first month in experimental groups, 1.9 times during the second and third months, and 1.3 times during the fourth month. The technique also seemed to decrease the risk of root resorption and improve molar anchorage. Moreover, it exhibited good periodontal tolerance. Current literature highlights the effectiveness of surgical decortications during the first three to four months after surgery. Longer prospective studies are needed to assess their long term effects.

Alveolar corticotomies by lasercision: a minimally invasive procedure to accelerate orthodontic treatments in adult patients

In our offices, more and more adults are visiting with the wish to align their teeth to preserve the aesthetics of their smile. However, treatment duration is the most common reason in the refusal to undergo orthodontic treatment. Alveolar corticotomies help accelerate and facilitate tooth movement. This is a surgical technique that consists of vertical scarifications of the vestibular interdental cortical bone to stimulate the alveolar bone metabolism. Current protocols, thanks to recent studies on bone physiology, are much less invasive than before and they allow more frequent indications for use of this technique, to meet the demands in adults.

Intrusion of Overerupted Molars by Corticotomy and Fixed Orthodontic Appliances

ABSTRACTIn this article, a review of the literature regarding the use of selective alveolar corticotomies (SAC) combined with orthodontic treatment was conducted, and the results of its use in a patient with overerupted maxillary 1st molars are described. Adequate intrusion was obtained within a short period of time, the protocol avoided the necessity of removal of sound tooth structure for crown lengthening, endodontic treatment, and full crown prosthetic restorations. Therefore, the obtained results indicate that SAC/orthodontic use is efficient in the intrusion of overerupted 1st molars and suggest its potential use in the treatment of other malocclusions.How to cite this articlede Souza MLAH, Soares RV, Zenóbio EG, Pithon MM, Oliveira DD. Intrusion of Overerupted Molars by Corticotomy and Fixed Orthodontic Appliances. Int J Experiment Dent Sci 2016;5(1):78-82.

Comparison of the Amount of Anchorage Loss of the Molars with and without the Use of Implant Anchorage during Anterior Segment Retraction Combined with Alveolar Corticotomies

Purpose: The purpose of this study was to evaluate the effect of alveolar corticotomies on anchorage loss by comparing and measuring the amount of anchorage loss with titanium mini-screws and conventional molar anchorage during anterior segment retraction. Materials and methods: In this study, we compared treatment outcomes of patients with severe class ІІ malocclusions treated using mini screw anchorage (n = 8) or traditional orthodontic mechanics of inclusion of the second molars (n = 8). Both methods were combined with alveolar corticotomies before retracting the anterior segment. Pretreatment and post treatment lateral cephalograms were analyzed. Results: Both treatment methods achieved acceptable results as indicated by the reduction of overjet. The mesiodistal position of the maxillary molars in group2 showed a small change (+1.5mm). Conclusion: Alveolar corticotomies on the anterior teeth combined with inclusion of second molars proved to be efficient for intraoral anchorage reinforcements for en-masse retraction of the maxillary anterior teeth.

Comparison of rate of maxillary canine movement with or without modified corticotomy facilitated orthodontic treatment: A prospective clinical trial

Background and Objectives The average orthodontic treatment time for extraction therapy is 31 months. One of the main disadvantages of orthodontic treatment is time. Alveolar corticotomies have been used in conjunction with orthodontics to reduce the treatment time by increasing the rate of tooth movement. Concerns about the possible risks of corticotomy procedure have led to the modification of this technique. Germeç et al. reported a case treated by their modified corticotomy technique and noted reduced treatment time without any adverse effects on the periodontium and the vitality of teeth with their new conservative corticotomy technique. This study was undertaken to clinically evaluate the efficacy of the aforesaid technique. Materials and Methods A split-mouth study design was carried out to compare the rate of maxillary canine movement with and without modified corticotomy facilitated orthodontic treatment in 10 patients requiring maxillary first premolar extractions. The modified corticotomy procedure was performed on the maxillary arch unilaterally. The upper arch was immediately activated bilaterally after surgical procedure using equal orthodontic forces for retraction of the maxillary canines. The amount of tooth movement was recorded at an interval of every month till the completion of canine retraction. The rate of canine movement on experimental and control site was compared. The patients were followed for 6 months to check the occurrence of undesired effects such as root resorption, periodontal damage and loss of vitality of teeth on the experimental side. Results Higher mean velocity was observed in canines with modified corticotomy facilitated retraction compared to conventionally retracted canines; with the difference in mean velocity between the two groups was found to be clinically significant as well as statistically significant (P < 0.001). Interpretation and Conclusion The results suggested that modified corticotomy technique serves as an effective and safe way to accelerate orthodontic tooth movement, without adversely affecting the periodontium, root resorption, and the vitality of the teeth, as concluded by clinical and radiographic examination.

Corticotomy-Assisted Le Fort I Osteotomy: An Alternative to Segmentation of the Maxilla in Orthognathic Surgery.

The aim of this study was to describe a surgical technique that can be used to solve dentofacial deformities associated with narrow interradicular spaces of the anterior teeth of the maxilla and inadequate overbite/overjet seen in hand-articulated models. This is presented here as an alternative to segmentation of the maxilla in Le Fort I osteotomy. Six patients with dentofacial deformities (classes II and III malocclusions) had Le Fort I osteotomy accompanied by buccal alveolar corticotomies of the maxilla. During the immediate postoperative period, elastic forces were applied to mobilize the anterior dentoalveolar segments until the planned overjet/overbite was observed. All patients reached the desired occlusion approximately 1 month after the surgical procedure. Pulp vitality of the teeth adjacent to the corticotomies was not compromised. The clinical results obtained confirm the technique as a safe and reliable alternative to segmentation of the maxilla in orthognathic surgery.

Formation osseuse et corticotomies à visée de facilitation métabolique : existe-t-il une ostéogénèse induite par les corticotomies alvéolaires ?

Current orthodontic treatments must answer an increasing demand for faster yet as efficient treatments, especially in adult patients. These past years, the amelioration of orthodontic, anesthetic and orthognathic surgery techniques have allowed considerable improvement of orthodontico-surgical treatments and of adult orthodontic treatments. Alveolar corticotomy (an example of such techniques) accelerates orthodontic tooth movements by local modifications of bone metabolism, inducing a transient osteopenia. This osteopenia allows greater tooth movements than conventional techniques. Whereas there is a growing understanding of the underlying biological mechanisms of alveolar corticotomies, there is little data regarding the osteogenic potential of such technique. In the present article, we review the literature pertaining to alveolar corticotomies and their underlying biological mechanisms and present a clinical case underlining the osteogenic potential of the technique.

Primary Failure of Eruption (PFE) and ankylosis of permanent molars: the surgeon’s experience

Eruption abnormalities involving permanent molars are clinically rare and can be particularly challenging to treat. When there is an obstacle in the eruption pathway, these teeth can be successfully set in the arch most of the time, once the obstacle is cleared. On the other hand, teeth afflicted with ankylosis or Primary Failure of Eruption (PFE) cannot be orthodontically displaced.PFE has a genetic origin and leads to open bite that can be severe, in relation to a reduced alveolar height. PFE is often also associated with class III malocclusion and dental agenesis, which makes the treatment plan even more complicated.This article first describes the characteristics of PFE and ankylosis and then presents our own experience, through several clinical cases. One case illustrates and discusses the limits of orthodontics in managing molars showing PFE, despite alveolar corticotomies and bone anchorage devices. Two other clinical cases describe global rehabilitation by osteotomy, bone graft and extensive prosthetic replacement.

Wilckodontics - a novel synergy in time to save time.

The systematic search for improvements in orthodontic therapy is shared by several dental specalities especially periodontics. Rapid orthodontic treatment procedures are now focusing on performing Alveolar Corticotomies (ACS) shortly before the application of orthodontic forces. This method has been suggested to enhance tooth movement and, consequently, reduces orthodontic treatment time as a whole. Thus, this article attempts to review the historical perspective of these therapeutic approaches, discusses the biological reasons underlying its use, mentions its main indications and contraindications and its modifications.

Corticotomias alveolares na Ortodontia: indicações e efeitos na movimentação dentária

INTRODUÇÃO: a busca pelo aumento na eficiência dos tratamentos ortodônticos é uma constante em diversas áreas da Ortodontia atual. A realização de corticotomias alveolares pouco antes da aplicação de forças ortodônticas vem sendo sugerida como uma forma de potencializar a movimentação dentária e, consequentemente, o tratamento ortodôntico como um todo. OBJETIVO: o presente artigo revê a perspectiva histórica dessa abordagem terapêutica, apresenta e ilustra com casos clínicos suas principais indicações e, por fim, discute os fundamentos biológicos que justificam sua utilização.

Tooth movements in foxhounds after one or two alveolar corticotomies

The aim of this split-mouth experimental study was to determine (1) whether corticotomy procedures increase tooth movement and (2) the effects of a second corticotomy procedure after 4 weeks on the rate of tooth movement. The mandibular third and maxillary second premolars of five skeletally mature male foxhounds, approximately 2 years of age, were extracted. One randomly selected mandibular quadrant had buccal and lingual flaps and corticotomies performed around the second premolar; the other quadrant served as the control. Both maxillary quadrants had initial buccal flaps and corticotomies; one randomly selected quadrant had a second buccal flap surgery and corticotomy after 28 days. Coil springs (200 g force), along with a 0.045 mm diameter tube on a 0.040 mm diameter guiding wire, were used to move the mandibular second and maxillary third premolars. Records, including digital calliper measurements and radiographs, were taken on days 0, 10, 14, 28, 42, and 56. Multilevel statistical procedures were used to model longitudinal tooth movements. The radiographic measurements initially showed increasing mandibular tooth movement rates, peaking between 22 and 25 days, and then decelerating. Total mandibular tooth movements were significantly (P < 0.05) greater on the experimental (2.4 mm) than on the control (1.3 mm) side. The rates of maxillary tooth movement slowed over time, with significantly (P < 0.05) more overall tooth movement on the side that had two (2.3 mm) than one (2.0 mm) corticotomy procedure. Alveolar corticotomy significantly increases orthodontic tooth movement. Performing a second corticotomy procedure after 4 weeks maintained higher rates of tooth movement over a longer duration and produced greater overall tooth movement than performing just one initial corticotomy, but the difference was small.

Accelerated orthodontic treatment by alveolar corticotomies: a clinical and experimental approach

Indications for orthodontic treatments are in constant augmentation in the adult population. Patients want the shortest possible treatments. Alveolar corticotomies speed up the tooth movement in comparison to conventional orthodontic treatments, therefore decrease treatment duration.This technique consists in the surgical section of cortical bone that leaves the medullar bone uninjured. The biological effects of corticotomies rely on decreasing medullary bone density and increasing bone remodelling activity (RAP regional acceleratory phenomenon).We are currently testing this combined approach of alveolar corticotomies and orthodontic treatments on a pig model with special attention given to potential secondary effects on pulp vitality, dental root morphology and length.We also present here two adult patients with malocclusion cases who underwent alveolar corticotomies as part of their surgical-orthodontic treatments.These experimental and clinical preliminary studies confirm that corticotomy requires a shorter time of orthodontic movement. Our clinical results showed that this technique resolves malocclusion at least twice as fast as conventional orthodontic treatment.No secondary effects of corticotomies on pulp vitality dental root morphology were observed.

Selective alveolar corticotomy to intrude overerupted molars

Orthodontic intrusion of overerupted molars in adults is challenging for most clinicians. Efficient intrusion can be achieved by combining selective alveolar corticotomies with a modified full-coverage maxillary splint to reduce surgical risks, treatment time, and costs for both orthodontists and patients.