Effect Of Corticotomy Research Articles

The Effects of Corticotomy and Piezocision in Orthodontic Canine Retraction: A Randomized Controlled Clinical Trial.

Background:There have been many studies and experiments to evaluate the effectiveness of different types of dental treatment. Maxillary canine extraction is such a dental treatment which can be performed through either alveolar corticotomy (AC) or piezocision (PZ). The current study aims to compare the effectiveness of these two types of dental procedures. It is based on a randomized clinical trial (RCT) through the split-mouth technique supported by a parallel group design. The participants in the trial were selected on the basis of a medical criterion. The clinical trial involved extraction of both the first maxillary premolar teeth through use of orthodontic instruments. This study aims to evaluate the comparative effectiveness of alveolar corticotomy and piezocision corticotomy in acceleration of maxillary canine retraction and how it can be used for expression of multiple bone remodeling gingival crevicular fluid (GCF). As part of this study, a RCT was performed on the basis of split-mouth technique at the Department of Orthodontics of Pontifical Catholic University at Minas Gerais in Brazil. The sample size for the clinical trial consisted of people who required extraction of maxillary premolar teeth after canine extraction. After digital intraoral scans, the cumulative distal movement of canines was measured on the basis of superimposition of digital model and the results were considered as the primary outcome of the study. The GCF bone remodeling samples were considered as the secondary outcomes.Results:50 patients, involving 22 males and 28 females were analyzed in this particular clinical trial. The age range that was considered for this clinical trial was 19–33 years. In case of understanding the distal movement between control and AC, no statistical significance was observed in Group1 (G1). Lower cumulative cervical and incisal measurements in case of PZ was lower than the measurement in the control state. In all the groups, the expression of the biomarkers had occurred in specific timepoints (P < 0.05) but no distinct pattern was observed.Conclusions:In order to accelerate the maxillary canine retraction, PZ and AC were ineffective. No distinct induction pattern of biomarker expression was noted as well.

The effects of corticotomy and piezocision in orthodontic canine retraction: a randomized controlled clinical trial

BackgroundThe aims of this study were to evaluate the efficacy of alveolar corticotomy (AC) and piezocision (PZ) in accelerating maxillary canine retraction, and their effects on multiple bone remodeling expression in gingival crevicular fluid (GCF). A split-mouth, randomized controlled clinical trial was performed at the Department of Orthodontics of Pontifical Catholic University of Minas Gerais, Brazil. Eligibility criteria included orthodontic need for first maxillary premolars extractions, followed by canine retraction. Fifty-one adult patients were recruited and randomly assigned to 3 groups (allocation ratio 1:1:1). Random allocation of surgical or control interventions to each side of the maxillary arch was also conducted: G1 − AC × Control, G2 − PZ × Control, and G3 − AC × PZ. Both the definition of the group and the decision of the experimental or control sides were randomized by the software. Intraoral digital scans were performed before, 7 and 14 days after the beginning of canine retraction, and subsequently, at every 14 days until a maximum period of 6 months. GCF samples were collected before, and 1, 2, 4, 8, and 12 weeks. The primary outcome consisted in the cumulative distal movement of the canines and was measured by digital model superimposition. The secondary outcome consisted in GCF bone remodeling samples that were quantified in a multiplex immunoassay. The measurements examinator was properly blinded.ResultsForty-seven patients, 19 males and 28 females, were analyzed (mean age 20.72, SD = 6.66, range 15 to 38). Statistically significant differences in canine distal movement between AC and control in G1 were not observed (p > 0.05). In G2, PZ showed lower cumulative incisal and cervical measurements than control from the 2nd to the 24th week (p < 0.05). In G3, PZ showed a lower cumulative incisal and cervical measurements than AC from the16th to the 24th week (p < 0.05). In all groups, differences on biomarkers expression occurred at specific timepoints (p < 0.05), but a distinct pattern was not observed.ConclusionsAC and PZ were not effective to accelerate maxillary canine retraction and did not induce a distinct pattern of biomarker expression.Trial registrationNCT03089996. Registered 24 March 2017 - Registered.

The effects of a corticotomy on space closure by molar protraction using TSADs in patients with missing mandibular first molars.

The purpose of this study was to evaluate the effects of a triangular-shaped corticotomy on the protraction of second and third molars in patients with missing mandibular first molars. The corticotomy and non-corticotomy groups consisted of sixteen first molars in fifteen patients (28.6±9.4years) and nineteen first molars in fifteen patients (26.6±8.4years), respectively. A triangular-shaped corticotomy was performed between the second premolar and molar. Temporary skeletal anchorage devices (TSADs) were placed between the first and second premolars in both groups. Mandibular dentition variables were measured on the pre and post-treatment panoramic radiographs and lateral cephalograms. Analysis of covariance was performed. The corticotomy group exhibited 2.8mm more inter-radicular correction between the second molar to second premolar roots (P<.001) and 1.6mm more inter-radicular distance correction between the third molar to second premolar roots compared to the non-corticotomy group (P<.01). The corticotomy group required 5.5months less treatment time for space closure (P<.05), but the total treatment time was the same for both groups. The inter-radicular distance between the mandibular second premolar and molar and treatment times for space closure was significantly reduced in the corticotomy group.

The effect of corticotomy on the compensatory remodeling of alveolar bone during orthodontic treatment

BackgroundThis study aimed to explore whether compensatory remodeling of the alveolar bone surface occurred during the buccal palatal movement of orthodontic teeth. We preliminarily explored whether corticotomy could activate or accelerate osteogenesis in the alveolar bone surface by measuring the expression of TGF-β1 (transforming growth factor-β1), which can facilitate the proliferation and differentiation of osteoblasts and regulate the maturity and formation of bone.MethodsSixty 10-week-old male Wistar rats were selected. In the orthodontic group, 20 rats were implanted with a constriction device between the maxillary first molars under general anesthesia. In the corticotomy group, 20 rats were implanted with a constriction device, and a palatal incision was made to penetrate the cortical bone. In the control group, 20 rats underwent no experimental operation except general anesthesia. After 1, 3, 5 and 7 days, the maxillary first molars and the surrounding alveolar bone were harvested, and coronal sections containing the apical mesial buccal root were prepared and observed using tetracycline fluorescence, HE staining and immunohistochemical staining for TGF-β1. Image-Pro Plus software was used to assess the immunohistochemical results, and SPSS 22.0 statistical software was used to analyze variance and perform the LSD test.ResultsThe tetracycline fluorescence results showed that in the periosteum near the apical region, an obvious fluorescence signal was observed in the orthodontic group and the corticotomy group compared with the control group. In the orthodontic group and corticotomy group, HE staining showed that the morphology was similar to cube-shaped. The immunohistochemical results showed that TGF-β1 was significantly increased in the periosteum near the apical region in the orthodontic group and corticotomy group, and there were significant differences among the three groups. In addition, the expression of TGF-β1 in the periosteum in the orthodontic group and the corticotomy group gradually increased over time, reaching a peak on day 5 and slightly decreasing on day 7.ConclusionOsteogenesis occurred on the alveolar bone surface during the buccal palatal movement of orthodontic teeth, and corticotomy had a positive effect, and TGF-β1 was involved in this process.

Does corticotomy accelerate canine retraction with adequate anchorage control? A split mouth randomized controlled trial

ABSTRACT Purpose: To assess the effects of corticotomy on the distal movement of canine and to assess the amount of molar anchor loss. Materials and Methods: 14 patients were selected for this prospective, split-mouth, randomized controlled trial. After bilateral maxillary first premolar extractions, corticotomy was done distal to canine on one side and 150 g of force was applied. The rate of canine and molar movement, tipping and rotation were evaluated for control and experimental side. The movement of canine and anchor loss was assessed at an interval of 3 weeks, using study models, till single canine retraction was complete. Subjective assessment of the post-surgical pain, swelling, discomfort and an overall patient perception of the surgical procedure was assessed at two time points. Results: There was a significant increase in the rate of canine movement on the experiment side at T1 and T2 (p ≤ 0.01). Anchor loss was found to be present on both the sides but the difference was not statistically significant (p > 0.05). The mesiodistal tipping of canine was found to be greater on the control side than the experiment side whereas there was no statistically significant difference in the mesiodistal tipping of the molar on either side (p > 0.05). The experiment group showed a greater rotation of canine than the control (p ≤ 0.05), however, the rotation of molar was statistically insignificant. Conclusion: Corticotomy-assisted canine retraction causes a significant increase in the rate of canine retraction for the initial 2 months of the post-corticotomy period.

Biomechanical effects of corticotomy facilitated orthodontic anterior retraction: a 3-dimensional finite element analysis

The objective of this study was to assess the biomechanical effects of different corticotomy designs used for orthodontic anterior retraction through finite element analysis. Materials and methods: A basic finite element model simulating retraction of anterior teeth was built reversely from CBCT films of an adult patient with protruded maxillary anterior teeth. Another thirteen FE models were created according to different corticotomy designs varied with site width and the extent of incision. The initial displacement, Von Mises stress and pressure stress of dento-alveolar structures was computerized and analyzed. Results: Corticotomy can increase the initial displacement of anterior segment including teeth and surrounding alveolar bone, change the distribution of Von Mises stress in cancellous bone and the pressure stress in periodontal ligament of anterior teeth. When the incision was near the periphery of apical, the anterior segment showed the greatest displacement, the cancellous bone at either sockets or incision region showed the maximum stress. Bilateral incision combined with palatal incision showed approximate initial displacement and stress distribution with circumscribing incision. While the incision width increased, the biomechanical effects of corticotomy amplified. Conclusions: Varied corticotomy designs can change the biomechanical effects on dento-alveolar structures. The incision near the periphery of apical and bilateral incision combined with palatal incision may be the optimized design used for retraction of anterior teeth.

Evaluation of the Effect of Corticotomy and Low Level Laser Therapy on Orthodontic Tooth Movement

Evaluation of the Effect of Corticotomy and Low Level Laser Therapy on Orthodontic Tooth Movement

Assessment of the effect of the corticotomy-assisted orthodontic treatment on the maxillary periodontal tissue in patients with malocclusions with transverse maxillary deficiency: a case series

BackgroundThe aim of the study was to assess the effect of corticotomy–assisted orthodontic treatment on soft tissue clinical parameters in patients with malocclusions with transverse maxillary deficiency.MethodsThe study included 20 generally healthy adult individuals with malocclusion, who underwent a corticotomy-assisted orthodontic treatment in maxilla. During the corticotomy performed after full-thickness flap elevation, only the buccal cortical plate was cut with the use of OTS-7, OTS7–4, OTS7-3 ultrasound tips of the piezosurgery device (Mectron s. p. a., Italy). A clinical examination was performed prior to the corticotomy procedure, then repeated – 3, 6, 9 and 12 months after the procedure. The following parameters were assessed: FMPI (full mouth plaque index), FMBOP (full mouth bleading on probing), PD (probing depth), CAL (clinical attachment level), GR (gingival recession height), RW (recession width), PH (papilla height), PW (papilla width), BS (bone sounding), biotype and KT.ResultsThere was a statistically significant reduction in PD (mean difference: 0.06; 95% Cl: − 0.33, − 0.18), CAL (mean difference: 0.07; 95% Cl: − 0.33, − 0.19), PH (mean difference: 0.26; 95% Cl: − 0.47, 0.05) and BS (mean difference: 0.13; 95% Cl: − 0.41, − 0.14) after the treatment. Statistically significant changes were also noted in relation to KT (mean difference: 0.17; 95% Cl: − 0.07, 0.27) and biotype (mean difference: 0.07; 95% Cl: 0.26, 0.39), which thickness increased significantly after the treatment. No statistically significant differences were observed in GR, RW and PW.ConclusionsThe corticotomy–assisted orthodontic treatment did not jeopardize the periodontal clinical status in maxilla. There is a need for further studies on a larger number of patient to compare the clinical findings with a control group as well as in patients with conventional orthodontic treatment in a longer follow-up time to find out more about the post-treatment periodontal tissue changes and stability.

Role of corticotomy in assisting space closure with atrophic alveolar ridge

To study the effect of corticotomy in assisting space closure in cases whose alveolar ridge atrophy was obvious after extraction. Twenty two cases whose canine's distal movement<0.2mm/m were selected, 12 accepted corticotomy and the other 12 were selected as the control group. All the spaces were closed with sliding mechanics under the help of microscrews. SPSS 13.0 software package was used for statistical analysis. All the spaces were closed. The canine's movement speed in the experimental group was superior to the control group(P<0.05), and the canine's movement was almost bodily movement (P<0.05); there was no obvious gingiva fold after space closure (P<0.05). There was no significant difference in the sulcus depth on the distal surface of the upper canine(P>0.05).

The effect of corticotomy on tooth movements during canine retraction

Objectives: The objective was to evaluate the effect of corticotomy/corticectomy surgery combined with fixed appliances on tooth movement during the canine retraction phase. Materials and Methods: We assessed 13 postpubertal patients (3 males and 10 females) requiring extraction of both maxillary first premolars. One side of the upper dental arch was treated with a PG retraction spring as a control, while the other side was treated with combined corticotomy/corticectomy surgery and a PG spring. A force of 100 g was used for canine retraction on both sides, with activation of the spring monthly on the control side and once every 15 days on the combined treatment side. A paired t-test was used to assess the difference between the two sides. Results: There was a small but statistically significant reduction in the duration of canine retraction (P < 0.05) and an increase in the rate of canine retraction (P < 0.05) (mm/month) in the combined treatment group. No difference in anchorage loss was observed between the groups. Tipping per millimeter of retraction was significantly different between the groups (P < 0.05). Conclusion: Corticotomy-assisted orthodontics increased the rate of tooth movement during canine retraction in 20% ratio. Relative bodily tooth movement was achieved with the corticotomy combined treatment.

Histological suture changes following retraction of the maxillary anterior bone segment after corticotomy.

By cephalometric and dental cast analyses, the effects of corticotomy in combination with 45-50 days retraction of the maxillary anterior segment were evaluated in five female Japanese monkeys (Macaca fuscata). In addition, microscopic changes of the related sutures were examined. According to the analyses of the dental casts, the retraction of the maxillary anterior segment in the experimental group was increased when compared with that of the control group. There was no change in occlusal molar relationship. The cephalometric analysis revealed that the "Point A" and "Metal Implant" on the mid-sagittal site between the upper central incisors in the experimental group showed more pronounced retraction than that in two untreated control animals. These results were histologically evaluated by changes of the suture structure: irregularity of functional arrangement of component cells and fibers, an increase in number of cells, resorption and formation of bone, and an enlargement of the suture width. Resorption of tooth roots and alveolar bone, and irregularity of the periodontal ligament were observed. In general, these histological changes appeared more extensive in the control specimens compared with the experimental specimens. The osseous histological changes were mainly observed in the compact bone area, while in the spongy bone area of both control and experimental specimens only minimal changes occurred. These results demonstrated the efficacy of combining a corticotomy procedure with retraction of the maxillary anterior bone segment by an orthodontic force.