jc-irf - copy / orthodontic courses by indian dental academy

JOURNAL CLUBJOURNAL CLUB

INDIAN DENTAL ACADEMY

Leader in continuing dental education www.indiandentalacademy.com

www.indiandentalacademy.comwww.indiandentalacademy.com

“ “ LOWER INCISOR RETRACTION LOWER INCISOR RETRACTION WITH A MODIFIED WITH A MODIFIED CORTICOTOMY “CORTICOTOMY “

AO 2006,76(6);880-88AO 2006,76(6);880-88


INTRODUCTIONINTRODUCTION SURGERY – combined for better SURGERY – combined for better

ortho Txortho Tx CORTICOTOMYCORTICOTOMY RAPRAP AOOAOO


CORTICOTOMYCORTICOTOMY “ “ Surgical removal of alveo bone “Surgical removal of alveo bone “ OROR Osteotomy of the cortical bonOsteotomy of the cortical bon

It distract the bone – growth of new boneIt distract the bone – growth of new bone

Moving group of teeth with alveo Moving group of teeth with alveo process- spongiosa intactprocess- spongiosa intact


Review of literatureReview of literature 1950 Periodontists - rate of OTM1950 Periodontists - rate of OTM 1959 Kole – 11959 Kole – 1stst labial & palatal labial & palatal

corticotomycorticotomy 1990 Dr.Wilcko: AOO - (CT scan) 1990 Dr.Wilcko: AOO - (CT scan)

mineralisation of alveolar bone – mineralisation of alveolar bone – responsible for OTMresponsible for OTM

2001 chung et al- ant retraction 2001 chung et al- ant retraction in bimaxin bimax


CORTICOTOMY IN CORTICOTOMY IN ORTHODONTICSORTHODONTICS Alternative Alternative to ortho Txto ortho Tx FASTER, less side effects & pt FASTER, less side effects & pt

compliancecompliance Moving blocks of boneMoving blocks of bone ORTHO Tx TIMEORTHO Tx TIME – resistance of – resistance of

the dense cortical bone to OTM is the dense cortical bone to OTM is removedremoved


INDICATIONS / USES :INDICATIONS / USES :

Non-growing / Old / faster ortho Non-growing / Old / faster ortho TxTx


Retraction- Class II div 1, bimaxRetraction- Class II div 1, bimax Spacing, rotationSpacing, rotation Intrusion (AOB)Intrusion (AOB) Ankylossis Ankylossis Teeth with narrow cortical boneTeeth with narrow cortical bone TSALDTSALD T/S constricted maxillaeT/S constricted maxillae


Advantages Advantages rate of OTM – Tx timerate of OTM – Tx time Avoid adverse effects of ortho Tx :Avoid adverse effects of ortho Tx : No gingival/PDL damageNo gingival/PDL damage Root resorptionRoot resorption Loss of vitality of teeth/boneLoss of vitality of teeth/bone Conservative surgeryConservative surgery No retention problems & tongue No retention problems & tongue

functions – after Txfunctions – after Txwww.indiandentalacademy.comwww.indiandentalacademy.com

Conventional :Conventional : Both B-L cutsBoth B-L cuts

2 stage surgery2 stage surgery

Modified :Modified : LABIAL- only no LABIAL- only no

lingual V & sub lingual V & sub apical H/Z cutsapical H/Z cuts

Conservative – Conservative – 1stge1stge

Less time & pt Less time & pt discomfortdiscomfort

Corticotomy site-Corticotomy site-mobilisedmobilised


AIMAIM

“ “ Rapid & effective modified Rapid & effective modified alveolar corticotomy-facilitated alveolar corticotomy-facilitated ortho Tx of an adult case with ortho Tx of an adult case with severe malocclusion - A CASE severe malocclusion - A CASE REPORT “REPORT “


Tx objectives:Tx objectives: Tx plan :Tx plan : X of al 4s-maxi anchorageX of al 4s-maxi anchorage Segmental canine retraction-at Segmental canine retraction-at

end accelaration by – end accelaration by – corticotomy-facilitated incisor corticotomy-facilitated incisor retraction retraction


Pre op – Pre op – OPG,OCCLUSALOPG,OCCLUSAL

Retraction-0.016 Retraction-0.016 x 0.022 S.S with x 0.022 S.S with T loop-1wk b4T loop-1wk b4


SURGERY :SURGERY : 0.5mm S.S bur, 0.5mm S.S bur,

1.5-2mm depth, 1.5-2mm depth, 2-3mm below 2-3mm below apicesapices


Immediate consolidationImmediate consolidation 3 wks- Dec OJ, Xn space closed3 wks- Dec OJ, Xn space closed LI retraction - 1.5 mosLI retraction - 1.5 mos No problems of No problems of

vascularity/vitality/root vascularity/vitality/root resoption/gingival resoption/gingival


ResultsResults Correction of pt Correction of pt

problem listproblem list Tx completion – Tx completion –

16 mos16 mos


ConclusionConclusion Effective alternative Tx – adults,sevre Effective alternative Tx – adults,sevre

malocclusion, malocclusion, the Tx time (50%)the Tx time (50%) Beneficial- in difficult surgical lingual Beneficial- in difficult surgical lingual

accessibilityaccessibility Modified CORTI- coservative, less Modified CORTI- coservative, less

time & pt discomfort, cost effectivetime & pt discomfort, cost effective Risk of tissue damage- Risk of tissue damage-

teeth,bone,PDLteeth,bone,PDLwww.indiandentalacademy.comwww.indiandentalacademy.com

Thank you

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