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Informationen aus Orthodontie & Kieferorthopädie 2014; 46(03): 153-163
DOI: 10.1055/s-0034-1387771
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Kortikotomie und Kompressionsosteogenese im Bereich der vorderen Maxilla: eine Lösung für schwierige Verhältnisse beim Schließen von Extraktionslücken

Corticotomy and Compression Osteogenesis in Anterior Maxilla: A Solution to Challenges of Extraction Space Closure
S.-H. Kim
1   Associate Professor and Chair, Department of Orthodontics, Kyung Hee University, School of Dentistry, Visiting Assistant Professor, Division of Orthodontics, University of California San Francisco, CA
,
W. Lee
2   Professor and Chairman, Department of Dentistry, Division of Oral and Maxillofacial Surgery, The Catholic University of Korea, Uijeongbu St Maryʼs Hospital, Korea
,
J.-B. Park
3   Private practice, Ansan, Gyeonggi-do, Korea
,
K.-R. Chung
4   Professor and Chairman, Department of Orthodontics, Ajou University, Suwon, Korea
,
H. Choo
5   Private Practice, San Francisco, CA
,
G. Nelson
6   Clinical Professor, Department of Orofacial Science, Division of ­Orthodontics, University of California San Francisco, USA
› Author Affiliations
Further Information

Publication History

Publication Date:
07 October 2014 (online)

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Zusammenfassung

Der vorliegende Beitrag stellt klinische Einsatzmöglichkeiten der perisegmentalen Kortikotomie und der Kompressionsosteogenese (speedy­ surgical orthodontics) zur Bewältigung von Problemen vor, die durch Zahnankylosen oder Dehiszenzen verursacht werden. Bei 2 Behandlungsfällen, bei denen ein vollständiger Schluss von Extraktionslücken durch Retraktion sämtlicher Frontzähne durch Zahnankylosen oder Wurzeldehiszenzen verhindert wurde, wurde eine perisegmentale Kortikotomie des anterio­ren maxillären Segmentes mit nachfolgender Biegung des Knochens durchgeführt, ohne dass sich die Inklination der Zähne gegenüber dem Alveolarknochen geändert hat. Im Anschluss an diese orthopädische Bewegung kam für kurze Zeit eine vollständige festsitzende labiale Apparatur zum Einsatz, mit der die Feinausrichtung der Okklusion erfolgte. Mithilfe der beschleunigten Bewegung von Zähnen und der orthopädischen Bewegung wurden optimale Werte für Overjet und Overbite sowie harmonische Gesichtsproportionen erreicht. Iatrogene Folgen von Zahnbewegungen, wie etwa Wurzelresorptionen, Knochennekrosen oder Gingivarezes­sionen, waren klinisch nicht von Bedeutung. Die schnelle chirurgisch-kieferorthopädische Behandlung ist ein effektives und effizientes Verfahren, um trotz vorhandener Zahnankylosen oder Dehiszenzen ein gutes Behandlungsergebnis erreichen zu können.

Abstract

This study presents clinical applications of perisegmental corticotomy and compression osteogenesis (speedy surgical orthodontics) to overcome challenges resulting from ankylosis or dehiscence. When ankylosis or root dehiscence prevent complete closure of extraction space during the active en masse retraction period, perisegmental corticotomy followed by orthopedic retraction was performed on the maxillary anterior segment to induce bone bending without tooth inclination within the bone. Following the orthopedic movement, a full fixed labial orthodontic appliance was used for a short period at the finishing stage to fine-tune the occlusion. Optimal overjet, overbite, and favorable facial ­balance were achieved by expedited dental move­ment as well as orthopedic movement. Any signs of iatrogenic consequences of tooth movement such as root resorption, bone necrosis, or gingival recession were clinically insignificant. Speedy surgical orthodontics is an effective and efficient treatment modality to achieve optimal treatment outcomes in orthodontics despite existing ankylosis or root dehiscence.

Schlüsselwörter

Wurzeldehiszenz - Ankylose - Miniplatte - Speedy Surgical Orthodontics - Kortikotomie - Kompressionsosteogenese

Key words

root dehiscence - ankylosis - miniplate - speedy surgical orthodontics - corticotomy - compression osteogenesis
 

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