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Corticotomy-assisted decompensation for augmentation of the mandibular anterior ridge.

Authors
Kim, SH; Kim, I; Jeong, DM; Chung, KR; Zadeh, H
Citation
American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics, 140(5):720-731, 2011
Journal Title
American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics
ISSN
0889-54061097-6752
Abstract
INTRODUCTION: This article introduces a technique combining corticotomy and orthodontic forces, or accelerated osteogenic orthodontics, for use in patients with a Class III occlusion and a thin alveolus who will undergo orthognathic surgery.



METHODS: Two adults with Class III malocclusion undergoing anterior decompensation for mandibular setback surgery were selected. The first patient was treated with accelerated osteogenic orthodontics and conventional decompensation. The second patient was treated with accelerated osteogenic orthodontics and decompensation with a temporary skeletal anchorage device in concert with guided tissue regeneration. Decortication of bone was performed to the mandibular teeth with a low-speed round bur and piezosurgery. After hemostasis, bone graft material was placed into the decorticated area. In the severely thin alveolar ridge, a rigid scaffold was applied for immobilization of graft material. After approximation of the flap, an immediate orthodontic force was applied to the teeth to initiate rapid tooth movement.



RESULTS: Rapid tooth movement into predetermined positions for orthognathic surgery was accomplished in all mandibular anterior teeth. Preoperative 3-dimensional imaging showed dehiscences on the facial aspects of the mandibular anterior teeth. Postoperative imaging demonstrated coverage of the denuded roots with radiodense material.



CONCLUSIONS: The accelerated osteogenic orthodontic technique is a safe and effective treatment option for mandibular anterior decompensation treatment of these patients. When combined with a temporary skeletal anchorage device and bone augmentation, this technique facilitated the decompression of the mandibular anterior teeth in severely compromised dentitions.
MeSH terms
AdultAlveolar Ridge Augmentation/*methodsBiomechanicsBone Remodeling/physiologyBone Transplantation/methodsFemaleFollow-Up StudiesGuided Tissue Regeneration/methodsHemostasis, Surgical/methodsHumansImaging, Three-Dimensional/methodsMalocclusion, Angle Class III/*surgeryMandible/*surgeryMembranes, ArtificialOrthodontic Anchorage Procedures/instrumentationOrthognathic Surgical Procedures/*methodsOsteogenesis/physiologyOsteotomy/*methodsOsteotomy, Le Fort/methodsOsteotomy, Sagittal Split Ramus/methodsPiezosurgery/methodsPrognathism/surgerySurgical Wound Dehiscence/etiologyTissue ScaffoldsTooth Movement/methods
DOI
10.1016/j.ajodo.2009.12.040
PMID
22051493
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Dentistry
AJOU Authors
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