1
|
Villamil-Jaramillo H, Guerrero-García J, Upegui-Ramirez M, Rivera-Quiroz LH, Vivares A, Ardila CM. Changes in Periodontal Tissues With Periodontally Accelerated Orthodontics: A Systematic Review and Meta-Analysis. Cureus 2024; 16:e68795. [PMID: 39371838 PMCID: PMC11456284 DOI: 10.7759/cureus.68795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2024] [Indexed: 10/08/2024] Open
Abstract
Periodontally accelerated orthodontic (PAO) therapy has been found to increase hard tissue, helping to decrease orthodontic relapse rates and improve retention capacity. The aim of this study was to synthesize available evidence on clinical and tomographic changes in periodontal tissues when using PAO techniques. A systematic review with meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and registered in the International Prospective Register of Systematic Reviews (PROSPERO). The search was carried out in PubMed, Embase, Cochrane, Web of Science, Scopus, and Google Scholar. Randomized and non-randomized clinical trials comparing PAO versus conventional orthodontics were included. Quality assessment was performed using the Downs & Black scale, and the risk of bias was assessed using the revised Cochrane risk-of-bias tool. Mean differences and 95% confidence intervals (CIs) were calculated, and the mean difference was divided by a t-test. During the initial search, 465 studies were identified. Five articles studying 130 patients were included, which assessed both clinical and tomographic changes, along with treatment duration. PAO was administered to patients with skeletal class III in three studies, to class II patients in one study, and to individuals with dental crowding in another study. Two studies showed a moderate risk of bias, and the rest showed a low risk. The meta-analysis revealed a vestibular bone thickness increase of 0.32 mm (0.56-008; P = 0.008), a reduction of 3.12 mm (2.15-4.08; P= 0.001) in gingival retraction, and a treatment duration that was 7.07 months (8.79-5.36; P = 0.001) shorter in patients subjected to PAO compared to those undergoing conventional orthodontic treatment. Considering the limitations of the study and acknowledging that definitive conclusions cannot be drawn, the findings suggest that treatment time decreased in patients undergoing PAO, with an increase in vestibular bone thickness and less gingival retraction observed in those undergoing this intervention.
Collapse
Affiliation(s)
| | | | | | - Leidys H Rivera-Quiroz
- Research Department, Faculty of Dentistry, Fundación Universitaria Visión de Las Américas, Medellín, COL
| | - Anny Vivares
- Research Department, Faculty of Dentistry, Fundación Universitaria Visión de Las Américas, Medellín, COL
| | - Carlos M Ardila
- Basic Sciences Department, Faculty of Dentistry, University of Antioquia, Medellín, COL
| |
Collapse
|
2
|
Zhang Y, Yan J, Zhang Y, Liu H, Han B, Li W. Age-related alveolar bone maladaptation in adult orthodontics: finding new ways out. Int J Oral Sci 2024; 16:52. [PMID: 39085217 PMCID: PMC11291511 DOI: 10.1038/s41368-024-00319-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 06/16/2024] [Accepted: 06/18/2024] [Indexed: 08/02/2024] Open
Abstract
Compared with teenage patients, adult patients generally show a slower rate of tooth movement and more pronounced alveolar bone loss during orthodontic treatment, indicating the maladaptation of alveolar bone homeostasis under orthodontic force. However, this phenomenon is not well-elucidated to date, leading to increased treatment difficulties and unsatisfactory treatment outcomes in adult orthodontics. Aiming to provide a comprehensive knowledge and further inspire insightful understanding towards this issue, this review summarizes the current evidence and underlying mechanisms. The age-related abatements in mechanosensing and mechanotransduction in adult cells and periodontal tissue may contribute to retarded and unbalanced bone metabolism, thus hindering alveolar bone reconstruction during orthodontic treatment. To this end, periodontal surgery, physical and chemical cues are being developed to reactivate or rejuvenate the aging periodontium and restore the dynamic equilibrium of orthodontic-mediated alveolar bone metabolism. We anticipate that this review will present a general overview of the role that aging plays in orthodontic alveolar bone metabolism and shed new light on the prospective ways out of the impasse.
Collapse
Affiliation(s)
- Yunfan Zhang
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Jiale Yan
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Yuning Zhang
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Hao Liu
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Bing Han
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China.
| | - Weiran Li
- Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| |
Collapse
|
3
|
Kadkhodazadeh M, Amid R, Moscowchi A, Mansouri H. Periodontal phenotype modification in orthodontic patients. J ESTHET RESTOR DENT 2024; 36:548-554. [PMID: 37850403 DOI: 10.1111/jerd.13149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/28/2023] [Accepted: 09/30/2023] [Indexed: 10/19/2023]
Abstract
OBJECTIVE The purpose of this study was to assess the feasibility of phenotype modification in orthodontic patients using combined bone and soft tissue grafting substitutes. CLINICAL CONSIDERATION The surgical procedure was conducted on 18 patients (3 males, 15 females). Periodontal phenotype modification was conducted using demineralized freeze-dried bone allograft and a xenogeneic collagen matrix. The following parameters were recorded for each tooth at baseline and 12-month follow-up: O'Leary plaque index (PI), probing depth (PD), bleeding on probing (BOP), gingival thickness (GT), keratinized tissue width (KTW), gingival recession (GR), and vestibular depth (VD). The results showed a statistically significant increase in GT (2.02 ± 0.39 mm), KTW (1.11 ± 0.82 mm), and VD (0.18 ± 1.16 mm) (p < 0.05). GR was also significantly decreased (1.02 ± 0.99 mm) (p < 0.05). CONCLUSION Within the limitation of this study, the proposed approach enhanced the periodontal condition in orthodontic patients. However, further studies with a larger sample size are needed to ensure long-term stability. CLINICAL SIGNIFICANCE Hard and soft tissue conditions have paramount importance for long-term periodontal stability. Phenotype modification in orthodontic patients can diminish the probability of adverse consequences and result in optimal esthetic outcomes. The proposed technique using combined bone and soft tissue substitutes indicated promising results and could be recommended in orthodontic patients with thin periodontal phenotypes.
Collapse
Affiliation(s)
- Mahdi Kadkhodazadeh
- Dental Research Center, Research Institute for Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Amid
- Dental Research Center, Research Institute for Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Anahita Moscowchi
- Dental Research Center, Research Institute for Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Mansouri
- Dental Research Center, Research Institute for Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Periodontics, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| |
Collapse
|
4
|
Zhou H, Zhang YF, Qi YX, Zhang QQ, Liu N, Chen Y. The efficacy and safety of corticotomy and periodontally accelerated osteogenic orthodontic interventions in tooth movement: an updated meta-analysis. Head Face Med 2024; 20:12. [PMID: 38368383 PMCID: PMC10874089 DOI: 10.1186/s13005-024-00409-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 01/22/2024] [Indexed: 02/19/2024] Open
Abstract
BACKGROUND The surgically facilitated orthodontic strategy has been a promising strategy for orthodontic treatment recently. Therefore, the present meta-analysis was conducted to assess the available scientific evidence regarding the clinical outcomes, including the potential detrimental effects associated with these surgical procedures, with the aim of providing much more evidence-based information for clinical practice. METHODS An electronic search of three databases (PubMed, Cochrane, and Embase) and a manual search of relevant articles published up to May 2023 were carried out. Clinical trials (≥ 10 subjects) that utilized surgically facilitated orthodontic strategies with clinical and/or radiographic outcomes were included. Meta-analyses and sub-group analyses were performed to analyze the standardized mean difference (SMD) or weighted mean difference (WMD), and confidence interval (CI) for the recorded variables. RESULTS Nineteen studies published from Oct 2012 to May 2023 met the inclusion criteria. Based on the analysis outcomes, corticotomy treatment significantly decreased the alignment duration (WMD: -1.08 months; 95% CI = -1.65, -0.51 months, P = 0.0002), and accelerated the canine movement (WMD: 0.72 mm; 95% CI = 0.63, 0.81 mm, P < 0.00001) compared to the traditional orthodontic group. The periodontally accelerated osteogenic orthodontic (PAOO) strategy markedly reduced the total treatment duration (SMD: -1.98; 95% CI = -2.59, -1.37, P < 0.00001) and increased the bone thickness (SMD:1.07; 95% CI = 0.74, 1.41, P < 0.00001) compared to traditional orthodontic treatment. CONCLUSION The present study suggests that facilitated orthodontic treatment in terms of corticotomy and PAOO strategy may represent attractive and effective therapeutic strategy for orthodontic patients.
Collapse
Affiliation(s)
- Huan Zhou
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- Department of Periodontology, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Yi-Fan Zhang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- Department of Periodontology, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Yan-Xin Qi
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- Department of Prosthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Qian-Qian Zhang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Na Liu
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- Department of Periodontology, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Yue Chen
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China.
- Department of Periodontology, College of Stomatology, Xi'an Jiaotong University, Xi'an, China.
| |
Collapse
|
5
|
Yu X, Duan X, Zhi C, Jiang Y, Chen Z, Zhang C. Orthodontic treatment of traumatically avulsed maxillary central incisors with bimaxillary dentoalveolar protrusion in an adult female: a case report. BMC Oral Health 2023; 23:468. [PMID: 37422648 PMCID: PMC10329787 DOI: 10.1186/s12903-023-03123-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 06/08/2023] [Indexed: 07/10/2023] Open
Abstract
BACKGROUND Clinicians agree that obtaining and retaining good treatment results for missing maxillary central incisors owing to trauma is not easy. Management of adult patients with permanent maxillary central incisor loss who visit the clinic with high expectations for aesthetics and function pose a significant diagnostic dilemma. Therefore, esthetic and functional outcomes should be taken into consideration when deciding the proper treatment method. The treatment described in this study aimed to reestablish smile esthetics by proposing an effective multidisciplinary clinical approach that includes orthodontic-prosthetic-periodontal procedures, optimally reduced lip protrusion, center dental midlines, and establishment of stable occlusion. CASE PRESENTATION The patient was a 19-year-old adult female with bimaxillary arch protrusion who had been wearing removable dentures for several years since the loss of her maxillary central permanent incisors. A multidisciplinary treatment including the extraction of two mandibular primary premolars was adopted. The treatment plan consisted of orthodontic space closure by shifting the adjacent teeth towards the central incisor spaces combined with appropriate morphologic remodeling and gingival reshaping to obtain good aesthetic and functional results. The duration to complete the orthodontic treatment was 35 months. Clinical and radiographic results after treatment suggested smile harmony with an improvement in the facial profile, good function of the occlusion, and a positive effect on bone remodeling in the area of the missing incisors during orthodontic tooth movement. CONCLUSIONS This clinical case illustrated the necessity for using multidisciplinary methods involving orthodontic, prosthodontic, and periodontic procedures to treat an adult female patient with bimaxillary arch protrusion and long-term absence of anterior teeth due to severe trauma.
Collapse
Affiliation(s)
- Xiaotong Yu
- Department of Orthodontics, Tianjin Stomatological Hospital, School of Medicine Nankai University, Tianjin, 300041, China
- Tianjin Key Laboratory of Oral and Maxillofacial Fuction Reconstruction, Tianjin Stomatological Hospital, Tianjin, 300041, China
| | - Xiaoni Duan
- Department of Orthodontics, Tianjin Stomatological Hospital, School of Medicine Nankai University, Tianjin, 300041, China
- Department of Orthodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, 310006, China
| | - Cheng Zhi
- Department of Orthodontics, Tianjin Stomatological Hospital, School of Medicine Nankai University, Tianjin, 300041, China
- School and Hospital of Stomatology, Tianjin Medical University, Tianjin, 300070, China
| | - Yilin Jiang
- Department of Orthodontics, Tianjin Stomatological Hospital, School of Medicine Nankai University, Tianjin, 300041, China
- Tianjin Key Laboratory of Oral and Maxillofacial Fuction Reconstruction, Tianjin Stomatological Hospital, Tianjin, 300041, China
| | - Ziyi Chen
- Department of Orthodontics, Tianjin Stomatological Hospital, School of Medicine Nankai University, Tianjin, 300041, China
- School and Hospital of Stomatology, China Medical University, Shenyang, 110001, China
| | - Chunxiang Zhang
- Department of Orthodontics, Tianjin Stomatological Hospital, School of Medicine Nankai University, Tianjin, 300041, China.
- Tianjin Key Laboratory of Oral and Maxillofacial Fuction Reconstruction, Tianjin Stomatological Hospital, Tianjin, 300041, China.
| |
Collapse
|
6
|
Ma H, Lyu H, Xu L, Hou J, Wang X, Li W, Li X. Augmented corticotomy-assisted presurgical orthodontic treatment to prevent alveolar bone loss in patients with skeletal Class III malocclusion. Am J Orthod Dentofacial Orthop 2023; 163:210-221. [PMID: 36328904 DOI: 10.1016/j.ajodo.2021.10.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 10/01/2021] [Accepted: 10/01/2021] [Indexed: 11/05/2022]
Abstract
INTRODUCTION The objective of this study was to explore the effect of augmented corticotomy (AC) on anterior alveolar bone morphology in presurgical orthodontic treatment for skeletal Class III malocclusion. METHODS Thirty-six surgical patients with skeletal Class III malocclusion with high-angle were included: 18 (AC group) accepted AC surgery during presurgical orthodontic treatment, and 18 (control group) accepted traditional presurgical orthodontic treatment. Cone-beam computed tomography scans were obtained before treatment (T0) and after presurgical orthodontic treatment (T1). The alveolar bone morphology, root length, dehiscence, and movement of mandibular central incisors were measured by cone-beam computed tomography using Dolphin software. Statistical analyses were performed with independent-sample t tests, paired t tests, and multiple linear regression. RESULTS After presurgical orthodontic treatment, the whole alveolar bone thickness at each level, alveolar bone area, and alveolar bone height decreased significantly in the control group but increased or remained unchanged in the AC group. In the AC group, the lower the labial alveolar bone height at T0 was, the greater the increase after T1; the change in alveolar bone thickness was related to ΔL1-MP and sex. At T0, the incidences of dehiscence were similar in the 2 groups, ranging from 11.11% to 16.67%. At T1, the labial and lingual incidences of dehiscence in the AC group were 0% and 27.78%, compared with 55.56% and 66.67% in the control group. CONCLUSIONS During presurgical orthodontic treatment, AC is effective in preventing alveolar bone resorption and dehiscence without additional root resorption. AC can be recommended for high-angle skeletal Class III patients with thin alveolar bone around anterior teeth during presurgical orthodontic treatment.
Collapse
Affiliation(s)
- Huimin Ma
- Department of Orthodontics, National Engineering Laboratory for Digital and Material Technology of Stomatology, and Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Hangmiao Lyu
- Department of Orthodontics, National Engineering Laboratory for Digital and Material Technology of Stomatology, and Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Li Xu
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, and Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Jianxia Hou
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, and Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xiaoxia Wang
- Department of Oral and Maxillofacial Surgery, National Engineering Laboratory for Digital and Material Technology of Stomatology, and Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Weiran Li
- Department of Orthodontics, National Engineering Laboratory for Digital and Material Technology of Stomatology, and Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China.
| | - Xiaotong Li
- Department of Orthodontics, National Engineering Laboratory for Digital and Material Technology of Stomatology, and Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China.
| |
Collapse
|
7
|
Wang B, Xi W, Chen H, Shao J, Song A, Zhang F. Periodontal effect of augmented corticotomy-assisted orthodontics versus conventional orthodontics in treatment of adult patients with bialveolar protrusion. BMC Oral Health 2022; 22:81. [PMID: 35305642 PMCID: PMC8933887 DOI: 10.1186/s12903-022-02107-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/02/2022] [Indexed: 11/22/2022] Open
Abstract
Background The patients of bialveolar protrusion always demonstrate thin anterior alveoli which may aggravate subsequent gingival recession and bone loss during retraction. This study aimed to investigate the periodontal changes, including alveolar height, thickness, and area, and the width of keratinized gingiva, in mandibular anterior teeth after augmented corticotomy-assisted orthodontics (ACAO) compared with traditional orthodontics. Methods Twenty adult patients with skeletal class I bialveolar protrusion were selected from two groups: ACAO group (augmented corticotomy on the labial side of the anterior mandibular teeth, n = 10) and control group (conventional orthodontics, n = 10). In all patients, four first premolars were extracted and the incisors were retracted under the maximum anchorage. The measurements included the labial alveolar bone area, vertical alveolar bone height, alveolar bone thickness surrounding the mandibular anterior teeth, root length, gingival recession and width of keratinized gingiva after alignment (T0) and 3 months after space closure (T1). Results The labial alveolar height, area, and thicknesses all decreased after space closure in the control group but significantly increased in the ACAO group. The decrease in the lingual alveolar height was statistically less in the ACAO group than that in the control group. Besides, the width of keratinized gingiva increased in the ACAO group but decreased in the control group. There was no significant difference in the changes of root length between groups. The dentoalveolar changes between anterior teeth were consistent but with different scales. The lateral incisors gained the most labial bone height and area. Conclusion Compared to conventional orthodontics, ACAO provided a more favorable effect of improving periodontal status surrounding the mandibular anterior teeth for Class I maxillary protrusion patients.
Collapse
|
8
|
Gao J, Nguyen T, Oberoi S, Oh H, Kapila S, Kao RT, Lin GH. The Significance of Utilizing A Corticotomy on Periodontal and Orthodontic Outcomes: A Systematic Review and Meta-Analysis. BIOLOGY 2021; 10:biology10080803. [PMID: 34440034 PMCID: PMC8389689 DOI: 10.3390/biology10080803] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/11/2021] [Accepted: 08/16/2021] [Indexed: 12/18/2022]
Abstract
Simple Summary The collaboration between periodontics and orthodontics has the potential to allow safer orthodontic tooth movement and improve vulnerable oral conditions especially for patients with very thin bone and soft tissue. By providing this interdisciplinary surgical approach where thin bone and soft tissue are surgically augmented to convert a fragile-thin to a robust-thick tissue phenotype, this permits orthodontic treatment in these previously thin tissue cases to proceed without iatrogenically induced adverse effects. This is an infrequently performed procedure with few clinical recommendations. This review paper provides the rationale and the currently available evidence on the benefits of this novel surgical approach. Abstract Purpose: This systematic review compares the clinical and radiographic outcomes for patients who received only a corticotomy or periodontal accelerated osteogenic orthodontics (PAOO) with those who received a conventional orthodontic treatment. Methods: An electronic search of four databases and a hand search of peer-reviewed journals for relevant articles published in English between January 1980 and June 2021 were performed. Human clinical trials of ≥10 patients treated with a corticotomy or PAOO with radiographic and/or clinical outcomes were included. Meta-analyses were performed to analyze the weighted mean difference (WMD) and confidence interval (CI) for the recorded variables. Results: Twelve articles were included in the quantitative analysis. The meta-analysis revealed a localized corticotomy distal to the canine can significantly increase canine distalization (WMD = 1.15 mm, 95% CI = 0.18–2.12 mm, p = 0.02) compared to a conventional orthodontic treatment. In addition, PAOO also showed a significant gain of buccal bone thickness (WMD = 0.43 mm, 95% CI = 0.09–0.78 mm, p = 0.01) and an improvement of bone density (WMD = 32.86, 95% CI = 11.83–53.89, p = 0.002) compared to the corticotomy group. Conclusion: Based on the findings of the meta-analyses, the localized use of a corticotomy can significantly increase the amount of canine distalization during orthodontic treatment. Additionally, the use of a corticotomy as a part of a PAOO procedure significantly increases the rate of orthodontic tooth movement and it is accompanied by an increased buccal bone thickness and bone density compared to patients undergoing a conventional orthodontic treatment.
Collapse
Affiliation(s)
- Jonathan Gao
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, CA 94131, USA; (J.G.); (T.N.); (S.O.); (S.K.); (R.T.K.)
| | - Trung Nguyen
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, CA 94131, USA; (J.G.); (T.N.); (S.O.); (S.K.); (R.T.K.)
| | - Snehlata Oberoi
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, CA 94131, USA; (J.G.); (T.N.); (S.O.); (S.K.); (R.T.K.)
| | - Heesoo Oh
- Department of Orthodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, CA 94103, USA;
| | - Sunil Kapila
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, CA 94131, USA; (J.G.); (T.N.); (S.O.); (S.K.); (R.T.K.)
| | - Richard T. Kao
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, CA 94131, USA; (J.G.); (T.N.); (S.O.); (S.K.); (R.T.K.)
- Private Practice, San Jose, CA 95125, USA
| | - Guo-Hao Lin
- Department of Orofacial Sciences, School of Dentistry, University of California San Francisco, San Francisco, CA 94131, USA; (J.G.); (T.N.); (S.O.); (S.K.); (R.T.K.)
- Correspondence:
| |
Collapse
|
9
|
Xu M, Sun XY, Xu JG. Periodontally accelerated osteogenic orthodontics with platelet-rich fibrin in an adult patient with periodontal disease: A case report and review of literature. World J Clin Cases 2021; 9:1367-1378. [PMID: 33644204 PMCID: PMC7896698 DOI: 10.12998/wjcc.v9.i6.1367] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 12/15/2020] [Accepted: 12/27/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND In the clinical scenario, adult patients with periodontal diseases and dental malformation, characterized by dental crowding in lower anterior teeth with the thin biotype, often require orthodontic treatment. This case report aimed to evaluate the clinical and radiographic outcomes of periodontally accelerated osteogenic orthodontics (PAOO) combined with autologous platelet-rich fibrin (PRF) in an adult patient with class I malocclusion along with dental crowding, a thin periodontal biotype, and buccal plate deficiency.
CASE SUMMARY A 32-year-old female complaining of dental crowding and gingival bleeding was referred to the orthodontic clinic. The patient underwent periodontal risk assessment prior to orthodontic treatment. She was diagnosed with a high risk of gingival recession due to dental crowding, root prominence, loss of buccal plates, and a thin gingival tissue biotype. The treatment regimen included PAOO combined with autologous PRF for alveolar augmentation and interproximal enamel reduction for moderate dental crowding. Clinically, PAOO-assisted orthodontic tooth movement in this case showed enhanced periodontium remodeling. Radiographic outcomes also showed statistically significant improvements (P < 0.01) in the mandibular buccal alveolar bone.
CONCLUSION This case report suggests the combination of autologous PRF with PAOO to enhance bone augmentation and long-term tissue support in adult orthodontic patients with periodontal disease.
Collapse
Affiliation(s)
- Min Xu
- Stomatological Hospital and College, Anhui Medical University, Hefei 230032, Anhui Province, China
| | - Xiao-Yu Sun
- Stomatological Hospital and College, Anhui Medical University, Hefei 230032, Anhui Province, China
| | - Jian-Guang Xu
- Department of Orthodontics, Anhui Medical University, Hefei 230032, Anhui Province, China
| |
Collapse
|
10
|
Brugnami F, Meuli S, Caiazzo A, Marrocco S, Scopelliti D. Three-dimensional digital planning of class III decompensation with clear aligners: Hard and soft tissue augmentation with concomitant corticotomy to stretch the limits of safe orthodontic treatment. J Oral Biol Craniofac Res 2021; 11:297-302. [PMID: 33732611 DOI: 10.1016/j.jobcr.2021.02.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/28/2021] [Accepted: 02/18/2021] [Indexed: 11/16/2022] Open
Abstract
Purpose Three-dimensional diagnosis has shown that orthodontic therapy could potentially move the roots of the teeth outside the original bone structure. The purpose of these case studies was to test the possibility of obtaining correct three-dimensional tooth positioning with clear aligners, thereby modifying the periodontal structure accordingly, at the same time. Methods Regenerative Corticotomy (RC) was performed with clear aligners on ten adult patients (40 anterior teeth) with skeletal Class III malocclusion, for dental decompensation, prior to the orthognathic surgery. The CBCT examinations were performed before treatment (T0) and 1 year after orthognathic surgery (T1). The vertical and the horizontal hard tissue changes, the width of keratinized gingiva, the incisors proclination (IMPA) and the percentage of inclination compared to the planning were analyzed. Results The distance between the Cemento-Enamel Junction (CEJ) and the Bone Marginal Level (BML) decreased in average from 5.5 ± 3.2 mm to 1.39 ± 0.53 mm. The horizontal changes were at the 3 mm level 1.42 ± 0.5 mm, at the 5 mm level 1.98 ± 0.66 mm and at the 7 mm level 2.70 ± 0.87 mm. The width of Keratinized gingiva changes were on average 1.42 ± 0.36 at T0 and 4.16 ± 2.25 at T1. All the changes were statistically significant with p < 0,05. The mean proclination based on IMPA values was +9.16 +-1.19°. The mean difference of the incisor's proclination compared to the digitally planned was -1 +-0.6° (89.87 +- 6.46%). Conclusion Clear Aligners with three-dimensional digital planning seems to be reliable in controlling teeth movements in the pre-orthognathic decompensation phase. Regenerative Corticotomy seems to have the ability to improve the periodontal tissues despite proclination.
Collapse
Affiliation(s)
| | - Simonetta Meuli
- Visiting Professor Tor Vergata University of Rome Italy, Via Ridolfino Venuti 36, 00189, Rome, Italy
| | - Alfonso Caiazzo
- Clinical Assistant Professor Department of Oral and Maxillofacial Surgery, MGSDM Boston University, Salerno Italy, Via Bottiglieri 32, 00035, Salerno, Italy
| | - Sergio Marrocco
- Department of Oral Maxillofacial Surgery San Filippo Neri Hospital Rome Italy, Smile House Italy, Operation Smile Foundation, Via Trionfale 1023, 00100, Rome, Italy
| | - Domenico Scopelliti
- Department of Oral Maxillofacial Surgery San Filippo Neri Hospital Rome Italy, Smile House Italy, Operation Smile Foundation, Via Trionfale 1023, 00100, Rome, Italy
| |
Collapse
|
11
|
Three-Dimensional Evaluation on Cortical Bone During Orthodontic Surgical Treatment. J Craniofac Surg 2021; 31:1637-1646. [PMID: 32502113 DOI: 10.1097/scs.0000000000006592] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Adult patients' severe malocclusions, especially the skeletal ones, cannot be exclusively solved by the orthodontic treatment and therefore a combined orthodontic-surgical treatment is necessary. Today, numerous software allows to plane and to visualize the final treatment results simulating the best therapeutic option. This is a retrospective experimental study that aims to analyze the changes in the buccal cortical bone in patients undergoing orthodontics surgeries and to evaluate the correlation between the dental movement and the changes in the relative bone cortex. The study sample consists of 32 subjects. By applying the CBCT radiographic examinations, the measurements were made in well-defined points of reference. The 3D study of the dental changes of position and the cortical buccal bone related variation, suggests how the determined orthodontic movement of the dental element does not achieve an easily predictable bone variation. Therefore, it also suggests that there is no direct proportionality relationship between the extent of bone apposition/reabsorption and dental movement.
Collapse
|
12
|
Sendyk M, Cevidanes LHS, Ruellas ACDO, Fattori L, Mendes FM, Paiva JBD, Rino Neto J. Three-dimensional evaluation of dental decompensation and mandibular symphysis remodeling on orthodontic-surgical treatment of Class III malocclusion. Am J Orthod Dentofacial Orthop 2020; 159:175-183.e3. [PMID: 33390311 DOI: 10.1016/j.ajodo.2019.12.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 11/01/2019] [Accepted: 12/01/2019] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The purposes of this research were to identify the buccolingual inclinations of the mandibular teeth and the mandibular symphysis remodeling that result from the orthodontic decompensation movement. METHODS The sample consisted of 30 adults with Class III dentofacial deformity, who had presurgical orthodontic treatment. Three-dimensional images were generated by cone-beam computed tomography scans at 2 different times (initial and before orthognathic surgery). Three-dimensional virtual models were obtained and superimposed using automated voxel-based registration at the mandible to evaluate B-point displacement, mandibular molar and incisor decompensation movement, and symphysis inclination and thickness. The 3-dimensional displacements of landmarks at the symphysis were quantified and visualized with color-coded maps using 3D Slicer (version 4.0; www.slicer.org) software. RESULTS The measurements showed high reproducibility. The patients presented mandibular incisor proclination, which was consistent with the movement of tooth decompensation caused by the presurgical orthodontic treatment. Statistically significant correlations were found between the inclination of the mandibular incisors, symphysis inclination, and B-point displacement. Regarding the thickness of the symphysis and the inclination of the incisors, no statistically significant correlation was found. CONCLUSIONS The buccolingual orthodontic movement of the mandibular incisors with presurgical leveling is correlated with the inclination of the mandibular symphysis and repositioning of the B-point but not correlated to the thickness of the symphysis.
Collapse
Affiliation(s)
- Michelle Sendyk
- Department of Orthodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil.
| | | | | | - Liana Fattori
- Department of Orthodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Fausto Medeiros Mendes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - João Batista de Paiva
- Department of Orthodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - José Rino Neto
- Department of Orthodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
13
|
Yao CCJ, Chang ZC, Lai HH, Hsu LF, Hwang HM, Chen YJ. Architectural changes in alveolar bone for dental decompensation before surgery in Class III patients with differing facial divergence: a CBCT study. Sci Rep 2020; 10:14379. [PMID: 32873841 PMCID: PMC7463229 DOI: 10.1038/s41598-020-71126-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 08/10/2020] [Indexed: 11/09/2022] Open
Abstract
This study aimed to investigate alveolar bone change around mandibular anterior teeth during orthodontic decompensation in patients with skeletal Class III malocclusion and different vertical facial patterns. The records of 29 consecutive Class III patients selected from those pending two-jaw orthognathic surgery were divided into low (≤ 28°), average (30°-37°), and high (≥ 39°) mandibular plane angle (MPA) groups. The DICOM files of CBCT scans and STL files of digital dental models, taken before (T1) and after (T2) presurgical orthodontic treatment, were imported into Dolphin imaging software to reconstruct dentoskeletal images. T1 and T2 images were superimposed and analyzed for bone thickness and height at the level of root apex on each mid-sagittal slice of six mandibular anterior teeth. Differences between T1 and T2 were analyzed by non-parametric tests and mixed-effect model analysis. The results showed that the measurements of alveolar bone height generally decreased after treatment, regardless of MPA. The facial divergence, incisor irregularity, tooth site, treatment time, and change in proclination were identified as the significant factors affecting alveolar bone thickness and height during treatment. The presurgical orthodontic treatment to decompensate mandibular anterior teeth should be very careful in all MPA groups.
Collapse
Affiliation(s)
- Chung-Chen Jane Yao
- School of Dentistry, National Taiwan University, No. 1, Chang-Te Street, Taipei City, 10048, Taiwan.,Divison of Orthodontics and Dentofacial Orthopedics, Department of Dentistry, National Taiwan University Hospital, Taipei City, Taiwan
| | - Zwei-Chieng Chang
- School of Dentistry, National Taiwan University, No. 1, Chang-Te Street, Taipei City, 10048, Taiwan.,Divison of Orthodontics and Dentofacial Orthopedics, Department of Dentistry, National Taiwan University Hospital, Taipei City, Taiwan
| | - Hsiang-Hua Lai
- School of Dentistry, National Taiwan University, No. 1, Chang-Te Street, Taipei City, 10048, Taiwan.,Divison of Orthodontics and Dentofacial Orthopedics, Department of Dentistry, National Taiwan University Hospital, Taipei City, Taiwan
| | - Li-Fang Hsu
- School of Dentistry, National Taiwan University, No. 1, Chang-Te Street, Taipei City, 10048, Taiwan.,Divison of Orthodontics and Dentofacial Orthopedics, Department of Dentistry, National Taiwan University Hospital, Taipei City, Taiwan
| | - Hann-Min Hwang
- School of Dentistry, National Taiwan University, No. 1, Chang-Te Street, Taipei City, 10048, Taiwan.,Divison of Orthodontics and Dentofacial Orthopedics, Department of Dentistry, National Taiwan University Hospital, Taipei City, Taiwan
| | - Yi-Jane Chen
- School of Dentistry, National Taiwan University, No. 1, Chang-Te Street, Taipei City, 10048, Taiwan. .,Divison of Orthodontics and Dentofacial Orthopedics, Department of Dentistry, National Taiwan University Hospital, Taipei City, Taiwan.
| |
Collapse
|
14
|
Guo R, Zhang L, Hu M, Huang Y, Li W. Alveolar bone changes in maxillary and mandibular anterior teeth during orthodontic treatment: A systematic review and meta-analysis. Orthod Craniofac Res 2020; 24:165-179. [PMID: 32779352 DOI: 10.1111/ocr.12421] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 08/03/2020] [Accepted: 08/05/2020] [Indexed: 12/17/2022]
Abstract
The association between tooth movement and remodelling of surrounding bone is controversial. To analyse the effect of tooth movement on alveolar bone changes in maxillary and mandibular anterior teeth by cone-beam computed tomography (CBCT). The Embase, Cochrane Library and Medline databases were searched without any language restrictions. Longitudinal studies using CBCT to observe alveolar bone changes of maxillary and mandibular anterior teeth during orthodontic treatment were included. Two independent reviewers performed the study selection, data extraction and methodological quality assessment. A total of 26 studies were included in this review, 14 of which were eligible for quantitative synthesis. In extraction cases, meta-analysis showed vertical bone loss on the labial (0.36 mm) and lingual (0.94 mm) sides of maxillary incisors, and lingual bone thickness decreased significantly at the cervical level (0.57 mm). In non-extraction cases, vertical alveolar bone loss was significant on the labial side (0.97 mm) and lingual side (0.86 mm) of mandibular incisors. Subgroup analysis for skeletal class III patients indicated that vertical alveolar bone loss was 1.16 mm on the labial side and 0.83 mm on the lingual side of mandibular incisors. The absence of high-quality studies and the high heterogeneity of the included studies were limitations of this systematic review and meta-analysis. Based on limited evidence, alveolar bone height and thickness, especially at the cervical level, decreased during both labial and lingual movement of anterior teeth.
Collapse
Affiliation(s)
- Runzhi Guo
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Liwen Zhang
- Department of Dental Medical Center, China-Japan Friendship Hospital, Beijing, China
| | - Menglong Hu
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Yiping Huang
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Weiran Li
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| |
Collapse
|
15
|
Ma H, Li W, Xu L, Hou J, Wang X, Ding S, Lv H, Li X. Morphometric evaluation of the alveolar bone around central incisors during surgical orthodontic treatment of high-angle skeletal class III malocclusion. Orthod Craniofac Res 2020; 24:87-95. [PMID: 32615016 DOI: 10.1111/ocr.12408] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 06/20/2020] [Accepted: 06/25/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To evaluate morphometric characteristics of alveolar bone around the incisors of high-angle skeletal class III patients receiving surgical orthodontic treatment. SETTING AND SAMPLE POPULATION Thirty high-angle skeletal class III patients (mean age, 20.94 ± 3.25 years) underwent cone-beam computed tomography before treatment (T0), after pre-surgical orthodontic treatment (T1) and after treatment (T2). MATERIALS AND METHODS The vertical bone level (VBL), alveolar bone thickness (ABT), alveolar bone area (ABA) and position of upper and lower central incisors (UCIs and LCIs) were evaluated. The ABT included five levels (4, 6, 8 mm from the cemento-enamel junction, midroot and root apex level). One-way repeated measures ANOVA with Bonferroni's multiple-comparison test and matched t test was performed to compare variables. RESULTS Before treatment, the average labial ABT was approximately 1 mm in UCIs and 0.38 ~ 0.79 mm in LCIs, and the VBL of the LCIs was over 2 mm. After treatment, the VBL increased by 2.19 ± 1.96 mm (P < .001) on the lingual side of UCIs and 2.78 ± 2.29 mm and 3.09 ± 2.52 mm on the labial and lingual sides of LCIs, respectively (all P < .001). ABT at every level decreased significantly, decreasing by 1.66 ± 1.93 mm at the 8 mm level of UCIs and 1.06 ± 1.01 mm at the apex of LCIs (P < .001). The lingual ABA of UCIs and LCIs decreased by over 50% (P < .001). CONCLUSIONS In high-angle skeletal class III patients, the condition of alveolar bone around UCIs and LCIs was extremely poor before treatment. Further alveolar bone resorption occurred during surgical orthodontic treatment. More attention should be paid to the movement of anterior teeth in cases of severe alveolar bone loss.
Collapse
Affiliation(s)
- Huimin Ma
- Department of Orthodontics, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Weiran Li
- Department of Orthodontics, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Li Xu
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Haidian District, Beijing, China
| | - Jianxia Hou
- Department of Periodontology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Haidian District, Beijing, China
| | - Xiaoxia Wang
- Department of Oral and Maxillofacial Surgery, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Shuai Ding
- Department of Orthodontics, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Hangmiao Lv
- Department of Orthodontics, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xiaotong Li
- Department of Orthodontics, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| |
Collapse
|
16
|
Kao RT, Curtis DA, Kim DM, Lin G, Wang C, Cobb CM, Hsu Y, Kan J, Velasquez D, Avila‐Ortiz G, Yu S, Mandelaris GA, Rosen PS, Evans M, Gunsolley J, Goss K, Ambruster J, Wang H. American Academy of Periodontology best evidence consensus statement on modifying periodontal phenotype in preparation for orthodontic and restorative treatment. J Periodontol 2020; 91:289-298. [DOI: 10.1002/jper.19-0577] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 12/20/2019] [Accepted: 12/20/2019] [Indexed: 11/10/2022]
Affiliation(s)
- Richard T. Kao
- Orofacial Sciences University of California San Francisco San Francisco CA
- Private practice Cupertino CA
| | - Donald A. Curtis
- Preventive and Restorative Dental Science University of California San Francisco San Francisco CA
| | - David M. Kim
- Oral Medicine Infection and Immunity Harvard School of Dental Medicine Boston MA
| | - Guo‐Hao Lin
- Orofacial Sciences University of California San Francisco San Francisco CA
| | - Chin‐Wei Wang
- Periodontics and Oral Medicine University of Michigan Ann Arbor MI
| | - Charles M. Cobb
- Department of Periodontology University of Missouri‐Kansas City Kansas City MO
| | - Yung‐Ting Hsu
- Department of Periodontics University of Washington Seattle WA
| | - Joseph Kan
- Department of Restorative Dentistry Loma Linda University Loma Linda CA
| | - Diego Velasquez
- Periodontics and Oral Medicine University of Michigan Ann Arbor MI
- Private practice Fenton MI
| | - Gustavo Avila‐Ortiz
- Department of Periodontics University of Iowa College of Dentistry Iowa City IA
| | - Shan‐Huey Yu
- Periodontics and Oral Medicine University of Michigan Ann Arbor MI
| | - George A. Mandelaris
- Periodontics and Oral Medicine University of Michigan Ann Arbor MI
- Private practice Chicago IL
| | - Paul S. Rosen
- Private practice Yardley PA
- Periodontics University of Maryland Baltimore MD
| | | | - John Gunsolley
- Department of Periodontology Virginia Commonwealth University Richmond VA
| | - Katie Goss
- American Academy of Periodontology Chicago IL
| | | | - Hom‐Lay Wang
- Periodontics and Oral Medicine University of Michigan Ann Arbor MI
| |
Collapse
|
17
|
Wang CW, Yu SH, Mandelaris GA, Wang HL. Is periodontal phenotype modification therapy beneficial for patients receiving orthodontic treatment? An American Academy of Periodontology best evidence review. J Periodontol 2019; 91:299-310. [PMID: 31670836 DOI: 10.1002/jper.19-0037] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 09/05/2019] [Accepted: 09/25/2019] [Indexed: 01/11/2023]
Abstract
BACKGROUND Orthodontic treatment can greatly impact the periodontium, especially in dentitions with a thin periodontal phenotype. Orthodontic tooth movement can result into iatrogenic sequelae to these vulnerable anatomic conditions, such as development and exacerbation of bony dehiscence or fenestration defects, which can manifest loss of periodontal support and gingival recession (GR). This systematic review aimed to investigate whether periodontal phenotype modification therapy (PhMT) involving hard tissue augmentation (PhMT-b) or soft tissue augmentation (PhMT-s) has clinical benefits for patients undergoing orthodontic treatment. METHODS An electronic search was performed in two major databases for journals published in English language from January 1975 to January 2019 and a hand search of printed journals was also performed to identify human clinical trials reporting clinical and radiographic outcomes of patients receiving orthodontic treatment with or without hard and soft tissue augmentation procedures. Data were extracted and organized into tables for qualitative assessment. RESULTS Eight studies were identified evaluating the outcomes of PhMT in patients undergoing orthodontic therapy. Six studies evaluated patients receiving PhMT-b via corticotomy-assisted orthodontic therapy (CAOT) and simultaneous bone augmentation while the other two received PhMT-s before tooth movement. No studies investigated PhMT-b alone without CAOT and most studies focused on the mandibular anterior decompensation movements. There was high heterogeneity in the study design and inconsistency of the reported outcomes; therefore, a meta-analysis was not performed. Evidence at this moment supports CAOT with hard tissue augmentation accelerated tooth movement. However, only two studies provided direct comparison to support that CAOT with PhMT-b reduced the overall treatment time compared with conventional orthodontic treatment. No periodontal complications or evidence of severe root resorption were reported for both groups. Four studies provided radiographic assessment of the PhMT-b and demonstrated increased radiographic density or thicker facial bone after the treatment. Two studies reported an expanded tooth movement. One study reported an increase in keratinized tissue width post-CAOT plus PhMT-b, while another study with a 10-year follow-up showed a lower degree of relapse using the mandibular irregularity index when compared with conventional tooth movement alone. Two studies examined the effect of PhMT-s before orthodontic treatment. Unfortunately, no conclusions can be drawn because of the limited number of studies with contradicting outcomes. CONCLUSIONS Within the limited studies included in this systematic review, PhMT-b via particulate bone grafting together with CAOT may provide clinical benefits such as modifying periodontal phenotype, maintaining or enhancing facial bone thickness, accelerating tooth movement, expanding the scope of safe tooth movement for patients undergoing orthodontic tooth movement. The benefits of PhMT-s alone for orthodontic treatment remain undetermined due to limited studies available. However, PhMT-b appears promising and with many potential benefits for patients undergoing orthodontic tooth movement. There is a need for a higher quality of randomized controlled trials or case control studies with longer follow-up to investigate the effects of different grafting materials and surgical sites other than mandibular anterior region.
Collapse
Affiliation(s)
- Chin-Wei Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Shan-Huey Yu
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| | - George A Mandelaris
- Private practice, Periodontal Medicine and Surgical Specialists, Chicago, IL.,Department of Graduate Periodontics, University of Illinois College of Dentistry, Chicago, IL
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI
| |
Collapse
|
18
|
Segmental Corticotomy-Assisted Orthodontic Treatment With Platelet-Rich Fibrin Augmentation of Class III Anomaly. J Craniofac Surg 2019; 30:2565-2569. [PMID: 31689732 DOI: 10.1097/scs.0000000000005755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This clinical report presents the outcomes of segmental corticotomy-assisted orthodontic treatment in a class III patient. A 13.5-year-old female patient presented with class III anomaly and a thin alveolus in the mandibular anterior region. After the alignment of the mandibular incisors, segmental corticotomy with platelet-rich fibrin (PRF) was performed in the mandibular incisor area to facilitate incisor retraction to ensure periodontal support after the changes in the inclination of the teeth. Lateral cephalograms were taken at the beginning (T0), precorticotomy (T1), at the end of the treatment (T2), and 2 years after the treatment (T3). Cone-beam computed tomography (CBCT) records were collected at the T1, T2, and T3 periods to evaluate the bone structures. The measurements included the inclination and the position of the mandibular incisors, symphysis width, symphysis height, B-B' width, cervical alveolar width, the vertical alveolar bone level on the labial and the lingual sides, and the amount of labial and lingual bone at the apex in the mandibular central incisor and canine areas.The class I molar and canine relationship was achieved in this borderline case. The amount of labial bone at the root apex and the B-B' width increased. A vertical alveolar bone gain was observed. The facial profile was improved significantly. The treatment outcome was stable at the 2-year follow-up. The segmental anterior mandibular corticotomy provided an effective correcting inclination of the mandibular teeth with the use of class III elastics. This technique ensured the maintenance of a sufficient amount of labial bone with no periodontal side effects.
Collapse
|
19
|
Vannala V, Katta A, Reddy MS, Shetty SR, Shetty RM, Khazi SS. Periodontal Accelerated Osteogenic Orthodontics Technique for Rapid Orthodontic Tooth Movement: A Systematic Review. J Pharm Bioallied Sci 2019; 11:S97-S106. [PMID: 31198320 PMCID: PMC6555327 DOI: 10.4103/jpbs.jpbs_298_18] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Aim: The aim of this review was to analyze the data in the available literature regarding aspects of periodontally accelerated orthodontic therapy such as reduction in treatment time, variation in surgical techniques, and patient satisfaction. Materials and Methods: An internet-based search was performed for the articles published between January 2008 and August 2018 using keywords periodontal accelerated orthodontic tooth movement, corticotomy, bone grafting, tooth movement, and treatment duration. A total of 84 articles were obtained from MEDLINE and Embase search engines, of which 31 articles were eligible to be included for the systematic review. Results: On analysis, it was observed that the earlier studies were predominantly pertaining to case reports. In the later part of the decade considered in this review, it was observed that the emphasis was given to clinical and animal studies. Conclusions: Most of the studies included in the review concluded that there was a significant reduction in orthodontic treatment duration using periodontal accelerated techniques compared to conventional orthodontic treatment.
Collapse
Affiliation(s)
- Venkataramana Vannala
- Department of Orthodontics, College of Dentistry, Gulf Medical University, Ajman, United Arab Emirates
| | - Anilkumar Katta
- Consultant Orthodontist, Smile 4 All Dental Clinic, Guntur, Andhra Pradesh, India
| | - Manchala S Reddy
- Department of Periodontics, College of Dentistry, Gulf Medical University, Ajman, United Arab Emirates
| | - Shishir R Shetty
- Department of Oral Medicine and Radiology, College of Dentistry, Gulf Medical University, Ajman, United Arab Emirates
| | - Raghavendra M Shetty
- Department of Pediatric Dentistry, College of Dentistry, Gulf Medical University, Ajman, United Arab Emirates
| | - Shakeel S Khazi
- Department of Prosthodontics, College of Dentistry, Gulf Medical University, Ajman, United Arab Emirates
| |
Collapse
|