RESUMEN
PURPOSE: This study used cone-beam computed tomography to evaluate morphologic changes of the mandibular anterior ridge after using augmented corticotomy plus accelerated orthodontia to decompensate mandibular incisors in patients with surgical skeletal Class III. MATERIALS AND METHODS: Fourteen patients (8 men, 6 women; mean age, 26.14 yr) with skeletal Class III were treated before orthognathic surgery with a technique that combined corticotomy, bone grafting, and accelerated orthodontic forces to decompensate the lower incisors. Three-dimensional cone-beam computed tomograms were taken before treatment (T0) and at the completion of presurgical orthodontic treatment (T1). Measurements of the amount of vertical alveolar bone changes and horizontal bone thickness at the midroot and root apex levels of the mandibular incisors were evaluated. RESULTS: All patients showed significant proclination of the mandibular incisors at T1. The mean alveolar bone thickness from T0 to T1 increased buccally at the midroot and apex levels, showing statistically significant horizontal bone augmentation at the labial side of the lower anterior mandibular teeth (P < .05). The mean amount of vertical bone change did not show any significant vertical loss of alveolar bone. CONCLUSION: This new combined technique provided adequate decompensation of the mandibular incisors by increasing horizontal bone thickness in the labial aspect of the mandibular anterior area, without any vertical bone loss. This approach decreases the risk of the typical periodontal complications associated with traditional orthodontics, such as marginal bone loss and gingival recession.
Asunto(s)
Tomografía Computarizada de Haz Cónico/métodos , Maloclusión de Angle Clase III/cirugía , Mandíbula/cirugía , Procedimientos Quirúrgicos Ortognáticos/métodos , Osteotomía/métodos , Técnicas de Movimiento Dental/métodos , Adulto , Pérdida de Hueso Alveolar/diagnóstico por imagen , Proceso Alveolar/diagnóstico por imagen , Proceso Alveolar/cirugía , Sustitutos de Huesos/uso terapéutico , Cefalometría/métodos , Durapatita/uso terapéutico , Femenino , Estudios de Seguimiento , Humanos , Imagenología Tridimensional/métodos , Incisivo/diagnóstico por imagen , Masculino , Mandíbula/diagnóstico por imagen , Membranas Artificiales , Osteotomía Le Fort/métodos , Osteotomía Sagital de Rama Mandibular/métodos , Piezocirugía/métodos , Estrés Mecánico , Ápice del Diente/diagnóstico por imagen , Técnicas de Movimiento Dental/instrumentación , Raíz del Diente/diagnóstico por imagenRESUMEN
INTRODUCTION: The early treatment of Class III malocclusion with a protraction facemask can produce forward movement of the maxilla but is generally associated with posterior rotation of the mandible and dentoalveolar compensations. This article shows the dental and skeletal effects of intermaxillary elastics applied to temporary anchorage devices in the treatment of maxillary deficient Class III patients. MATERIALS AND METHODS: A total of 6 patients with skeletal Class III malocclusion were treated with intermaxillary elastics only. This traction was applied between modified miniplates placed in the maxilla and a modified lower acrylic resin plate bonded on mandibular tooth surfaces. To evaluate the orthodontic changes, lateral cephalograms were taken at the start of the treatment (T1), at the end of the orthopaedic treatment (T2) and at the follow-up (T3). RESULTS: All patients showed orthopaedic correction of the skeletal Class III relationship with reduction of facial concavity. No dentoalveolar compensations or changes in mandibular position were observed. CONCLUSION: The treatment of maxillary deficiency with orthopaedic forces from skeletal anchorage directed to the hooks of a modified lower acrylic resin plate bonded on the mandibular tooth surfaces, seems to be a promising technique.