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Accelerated decompensation of mandibular incisors in surgical skeletal class III patients by using augmented corticotomy: a preliminary study

Authors
Ahn, HW; Lee, DY; Park, YG; Kim, SH; Chung, KR; Nelson, G
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, 142(2):199-206, 2012
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: Our objectives were to evaluate the amount of decompensation of the mandibular incisors and the change of periodontal support around them after corticotomy with bone augmentation before orthognathic surgery.



METHODS: Before orthognathic surgery for 15 skeletal Class III patients, orthodontic treatment was combined with corticotomy and bone augmentation labially to the anterior mandibular roots. Lateral cephalograms were taken before orthodontic treatment and before surgery (completion of preoperative orthodontic treatment). The amounts of mandibular incisor proclination, alveolar bone thickness, and periodontal support (gingival margin levels and augmentation pattern) were evaluated.



RESULTS: Significant proclination of the mandibular incisors was shown after decompensation (P <0.001; incisor mandibular plane angle, 10.45°; incisor symphyseal plane angle, 10.74°). The incisor edge moved labially by 3.47 mm. The alveolar bone thickness increased by 1.56 mm at the root apex and 1.98 mm at the level of B-point (P <0.001). There was no gingival recession irrespective of the degree of proclination of the mandibular incisiors. Two types of bone augmentation pattern were evident. One was characterized by alveolar bone proclination proportional to the labial tipping of the mandibular incisors. Buccal alveolar bone at the cervical area was well maintained (60%, 9 subjects). The other showed greater increases in alveolar thickness at B-point than at the cervical area (40%, 6 subjects).



CONCLUSIONS: The augmented corticotomy provided effective decompensation of the mandibular incisors in skeletal Class III patients while maintaining labial bone thickness and with no periodontal side effects. This technique reduces or eliminates the risk of moving the roots through the labial plate during decompensation with the associated risk of gingival recession.
MeSH terms
AdultAlveolar Process/pathologyAlveolar Ridge Augmentation/*methodsBone Matrix/transplantationBone Substitutes/therapeutic useCephalometry/methodsFemaleGingiva/pathologyGingival Recession/prevention & controlHumansIncisor/*pathologyMaleMalocclusion, Angle Class III/*surgeryMandible/*surgeryMinerals/therapeutic useOrthognathic Surgical Procedures/methodsOsteotomy/*methodsOsteotomy, Le FortOsteotomy, Sagittal Split RamusPiezosurgerySurgical FlapsTooth Apex/pathologyTooth Cervix/pathology
DOI
10.1016/j.ajodo.2012.03.028
PMID
22858329
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Dentistry
AJOU Authors
정, 규림
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