Predictability of a New Orthodontic Extrusion Technique for Implant Site Development: A Retrospective Consecutive Case-Series Study

Abstract

In clinical daily practice, there are situations in which implant sites have vertical and/or horizontal bone defects and often we must improve their morphology and dimensions before fixture insertion. It is crucial to carefully evaluate the surgical site as regards the characteristics of both hard and soft tissues. The orthodontic extrusion technique can be used for nonsurgical augmentation of the implant site as an alternative to traditional regenerative/reparative surgical therapies. The orthodontic extrusion is based on a biological mechanism that uses the portion of periodontal ligament, still present on the root before the tooth extraction, for the increase of hard and soft tissues. In the literature, there is no evidence of common guidelines for this technique but only tips based on personal experience and/or previous studies. The aim of this study was to investigate and to validate the reliability of a new orthodontic extrusion technique (MF Extrusion Technique, by Dr. Mauro Fadda) by means of a retrospective consecutive case-series study. After we have done a review of the literature, we evaluated the X-rays of twelve consecutively treated patients before the orthodontic extrusion (T0) and after the stabilization period (T1), in order to quantify, by two different measurements, area and linear, the bone gain obtained by the application of the new technique. All the patients examined showed a significant increase in bone areas with an average value of 31.575 mm2. The linear bone gain had an average value of 4.63 mm. Data collected were statistically analysed by the Wilcoxon signed-rank test. The results obtained both from area and linear measurements at T0 and at T1 times showed that there was a statistically significant bone gain with p<0.01.

Klinikiniai Ortodontinės Ekstruzijos Dantų Restauracinio Gydymo Aspektai

“…Yra du pagrindiniai OE atlikimo būdai: fiksuotais aparatais, tokiais kaip breketai ir nuimamais, tokiais, kaip skaidrios kapos [4]. Paprastai rekomenduojamas ekstruzijos greitis yra 1-2 mm per mėnesį, o priimtinos jėgos priekiniams ir šoniniams dantims atitinkamai yra 15 g ir 50 g [14]. Taikomą jėgą galima kontroliuoti pagal jos tipą, dydį ir trukmę.…”

“…Konkretus stabilizavimo laikas prieš restauraciją literatūroje nėra tiksliai nurodytas, tačiau skirtingais duomenimis rekomenduojamas stabilizacijos laikotarpis nuo 1 iki 6 mėnesių. Paprastai, atliekant danties vainiko pailginimą, OE reikia mažiau laiko nei implantacijos vietos kūrimui, nes pastaruoju atveju reikia papildomo laiko alveoliniam kaului subręsti, kad būtų galima tikėtis pakankamo stabilumo vienmomentinės implantacijos metu [14,15].…”

Endodontics-orthodontics interrelationship: a review.

“…Several techniques are available today by using resorbable and nonresorbable devices. These are invasive techniques with a high degree of morbidity and a risk of failure (Conserva et al, 2020). The immediate implant procedure in the aesthetic zone is to furnish a peri-implant tissue architecture that facilitates the establishment of close-to-nature functional and esthetic outcomes.…”

“…Orthodontic forces used during extrusion ranged from 15 g to >80 g; the lowest values are normally used for the anterior teeth or single-rooted teeth, whereas the highest values were for posterior teeth (Conserva et al, 2020). On the other hand, the extrusion speed (mm/month) found was between 0 and 2 mm per month (Conserva et al, 2020). After the tooth has been extruded, it should be stabilised for 6 to 12 weeks to allow for tooth stabilisation and bone consolidation.…”

The effect of orthodontic extrusion on alveolar bone - a prospective clinical study

“…Treatment of missing teeth, with the alveolar ridge resorption, often requires multidisciplinary approach. Orthodontic tooth movement affects the surrounding periodontal tissue, depending on the direction of the orthodontic force application [5].…”