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

Abstract

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.

Accelerated Canine Retraction by Corticotomy Assisted or Periodontal Distraction

“…Conventional orthodontic treatment especially that involves extraction therapy is long treatment time; it may last for about 31 months (32) . Therefore, many patients may avoid orthodontic treatment (18) . Long orthodontic treatment time may resulted in root resorption, gingivitis, and caries (33) .…”

“…Also, surgery in the alveolar bone resulted in its injury with subsequent decrease in its bone density thus decreasing its resistance to orthodontic tooth movement (17) . A combination of conventional orthodontic and a surgical technique have been done to improve and accelerate the treatment (18) . Among these surgical procedures, micro-osteoperforations (MOPs) which is a safe and Less invasive multiple trans-mucosal perforations within alveolar bone which done in the region of desired tooth movement (19)(20) .…”

“…A corticotomy is another surgical procedure used to accelerate the rate of tooth movement by which the teeth forms a separate block with its own surrounding bone connected with the surrounding structures via medullary bone after cutting the buccal and lingual cortical plates with surgical bur after flab elevation. (18,23) Actually, orthodontic tooth movement involving corticotomy can be considered as a process of moving blocks of bone rather than moving only the teeth themselves (24) . It was reported that corticotomy can accelerate the rate of tooth movement either due to: a alterations within the periodontal ligament, increase in bone turnover, demineralization process in the cancellous bone surrounding the socket, earlier bone resorption due to earlier removal of hyaline and decreased resistance of the dense cortical bone.…”

Effectiveness of electric toothbrush as vibration method on orthodontic tooth movement: a split-mouth study

“… 1 - 3 One of the common deterrents to orthodontic therapy is the amount of time in which a patient needs to commit, thus, there has been a continuous search for techniques to accelerate the rate of orthodontic tooth movement. 4 At present, there are various invasive techniques to accelerate the rate of orthodontic tooth movement, namely: surgically facilitated orthodontics; 5 combination of interradicular corticotomy and supra-apical osteotomy technique; 6 , 7 periodontal ligament distraction; 8 undermining of interseptal bone; 9 the corticotomy-facilitated technique; 10 dentoalveolar distraction osteogenesis; 11 micro-osteoperforation, 12 and piezopuncturing. 13 …”

Efficacy of Modified corticotomy technique combined with skeletal anchorage in maxillary dentoalveolar class II malocclusion correction

“…A corticotomy is characterized as a surgery whereby just the cortical bone is cut, punctured, or precisely adjusted through both the buccal and/ or lingual cortical plates that encompass the tooth, only through the medullary bone (2) .…”