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Informationen aus Orthodontie & Kieferorthopädie 2015; 47(02): 93-104
DOI: 10.1055/s-0035-1555769
Übersichtsartikel
© Georg Thieme Verlag KG Stuttgart · New York

Chirurgisch unterstützte kieferorthopädische Behandlung: eine systematische Übersicht[*]

Surgically Facilitated Orthodontic Treatment: A Systematic Review
E. J. Hoogeveen
1   Department of Orthodontics, University Medical Center Groningen, University of Groningen, Groningen, Niederlande
,
J. Jansma
2   Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, Niederlande
,
Y. Ren
3   Professor, Department of Orthodontics, University Medical Center Groningen, University of Groningen, Groningen, Niederlande
› Author Affiliations
Further Information

Publication History

Publication Date:
03 July 2015 (online)

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Zusammenfassung

Einführung: Zur Verkürzung der Behandlungsdauer bei Jugendlichen und Erwachsenen sind Kortikotomien und dentale Distraktionsverfahren als effektive und sichere Maßnahmen vorgestellt worden. Im Rahmen einer systematischen Übersichtsarbeit sollte die Evidenz dieser Aussagen überprüft werden.

Methoden: Die Literaturdatenbanken PubMed, Embase und Cochrane wurden bis April 2013 nach randomisierten kontrollierten Studien, kontrollierten klinischen Untersuchungen und Fallserien mit 5 oder mehr Fällen durchsucht, die sich mit der Schnelligkeit der Zahnbewegung, der Verkürzung der Behandlungsdauer und mit Komplikationen bei verschiedenen chirurgischen Protokollen beschäftigt hatten. Die Suche wurde auf sämtliche Publikationssprachen ausgedehnt. Die Veröffentlichungen wurden systematisch auf ihre Eignung hin überprüft und 2 Bearbeiter beurteilten die methodische Qualität der ausgewählten Untersuchungen mithilfe eines vorab festgelegten Bewertungssystems.

Ergebnisse: Insgesamt 18 Veröffentlichungen konnten in die Auswertung aufgenommen werden. Bei 7 dieser Studien handelte es sich um klinische Untersuchungen mit kleinen Patientengruppen. Sämtliche Studien hatten ein mittleres oder niedriges Evidenzniveau. Die chirurgische Unterstützung wurde bei unterschiedlichen klinischen Problemen durchgeführt. Sämtliche Veröffentlichungen berichten von einer temporär beschleunigten Bewegung der Zähne nach dem chirurgischen Eingriff. In keiner der Studien konnten negative Auswirkungen auf die Parodontien, ein Vitalitätsverlust der Zähne oder Wurzelresorptionen festgestellt werden. Aufgrund methodischer Mängel und der kleinen Patientengruppen ist das Evidenzniveau für diese Ergebnisse beschränkt. In die Auswertung konnte keine Untersuchung zur Langzeitstabilität der Behandlungsergebnisse einbezogen werden.

Schlussfolgerungen: Die auf Grundlage der zurzeit verfügbaren Studien mit mittlerem bis niedrigem Evidenzniveau ermittelte Evidenz weist darauf hin, dass chirurgisch unterstützte kieferorthopädische Verfahren keine Gefahr für die oralen Gewebe darstellen und dass sie durch eine temporäre Phase beschleunigter Zahnbewegung charakterisiert sind. Dadurch kann die Dauer einer kieferorthopädischen Behandlung verkürzt werden. Allerdings existiert bisher keine prospektiv angelegte Studie, in der die Gesamtdauer einer Behandlung und die Langzeitstabilität der Behandlungsergebnisse im Vergleich mit einer Kontrollgruppe untersucht worden sind. Für sichere Aussagen sind immer noch gut durchgeführte prospektive Studien erforderlich.

Abstract

Introduction: Corticotomy and dental distraction have been proposed as effective and safe methods to shorten orthodontic treatment duration in adolescent and adult patients. A systematic review was performed to evaluate the evidence supporting these claims.

Methods: PubMed, Embase, and Cochrane databases were searched until April 2013 for randomized controlled trials, controlled clinical trials, and case series with 5 or more subjects that focused on velocity of tooth movement, reduction of treatment duration, or complications with various surgical protocols. There were no language restrictions during the search phase. Publications were systematically assessed for eligibility, and 2 observers graded the methodologic quality of the included studies with a predefined scoring system.

Results: 18 articles met the inclusion criteria. 7 studies were clinical trials, with small investigated groups. Only studies of moderate and low values of evidence were found. Surgically facilitated treatment was indicated for various clinical problems. All publications reported temporarily accelerated tooth movement after surgery. No deleterious effects on the periodontium, no vitality loss, and no severe root resorption were found in any studies. However, the level of evidence to support these findings is limited owing to shortcomings in research methodologies and small treated groups. No research concerning long-term stability could be included.

Conclusions: Evidence based on the currently available studies of low-to-moderate quality showed that surgically facilitated orthodontics seems to be safe for the oral tissues and is characterized by a temporary phase of accelerated tooth movement. This can effectively shorten the duration of orthodontic treatment. However, to date, no prospective studies have compared overall treatment time and treatment outcome with those of a control group. Well-conducted, prospective research is still needed to draw valid conclusions.

Schlüsselwörter

Kortikotomie - dentoalveoläre Distraktion - systematische Übersicht

Key words

corticotomy - dentoalveolar distraction - systematic review

* Dieser Artikel ist im englischsprachigen Original erschienen in: Am J Orthod Dentofazial Orthop 2014; 145: S51–S64. Der Abdruck erfolgt mit freundlicher Genehmigung.


 

  • Literatur

  • 1 Dibart S, Sebaoun JD, Surmenian J. Piezocision: a minimally invasive, periodontally accelerated orthodontic tooth movement procedure. Compend Contin Educ Dent 2009; 30: 342-344 346, 348-350
    Google Scholar
  • 2 Hernández-Alfaro F, Guijarro-Martínez R. Endoscopically assisted tunnel approach for minimally invasive corticotomies: a preliminaryreport. J Periodontol 2012; 83: 574-580
    CrossrefPubMedGoogle Scholar
  • 3 Roblee RD, Bolding SL, Landers JM. Surgically facilitated orthodontic therapy: a new tool for optimal interdisciplinary results. Compend Contin Educ Dent 2009; 30: 264-275
    PubMedGoogle Scholar
  • 4 Suya H. Corticotomy in orthodontics. In: Hösl E, Baldauf A. (eds.) Mechanical and Biological Basics in Orthodontic Therapy. Hüthig Medizin GmbH; Heidelberg: 1991: 207-226
    Google Scholar
  • 5 Köle H. Surgical operations on the alveolar ridge to correct occlusal abnormalities. Oral Surg Oral Med Oral Pathol 1959; 12: 515-529
    Google Scholar
  • 6 Wilcko WM, Wilcko MT, Bouquot JE et al. Rapid orthodontics with alveolar reshaping: two case reports of decrowding. Int J Periodontics Restorative Dent 2001; 21: 9-19
    Google Scholar
  • 7 Wilcko MT, Wilcko WM, Bissada NF. An evidence-based analysis of periodontally accelerated orthodontic and osteogenic techniques: a synthesis of scientific perspectives. Semin Orthod 2008; 14: 305-316
    Google Scholar
  • 8 Vercellotti T, Podesta A. Orthodontic microsurgery: a new surgically guided technique for dental movement. Int J Periodontics Restorative Dent 2007; 27: 325-331
    PubMedGoogle Scholar
  • 9 Bertossi D, Vercellotti T, Podesta A et al. Orthodontic microsurgery for rapid dental repositioning in dental malpositions. J Oral Maxillofac Surg 2011; 69: 747-753
    CrossrefPubMedGoogle Scholar
  • 10 Akay MC, Aras A, Günbay T et al. Enhanced effect of combined treatment with corticotomy and skeletal anchorage in open bite correction. J Oral Maxillofac Surg 2009; 67: 563-569
    Google Scholar
  • 11 Aboul-Ela SM, El-Beialy AR, El-Sayed KM et al. Miniscrew implant-supported maxillary canine retraction with and without corticotomy-facilitated orthodontics. Am J Orthod Dentofacial Orthop 2011; 139: 252-259
    Google Scholar
  • 12 Fischer TJ. Orthodontic treatment acceleration with corticotomy-assisted exposure of palatally impacted canines. Angle Orthod 2007; 77: 417-420
    Google Scholar
  • 13 Liou EJ, Huang CS. Rapid canine retraction through distraction of the periodontal ligament. Am J Orthod Dentofacial Orthop 1998; 114: 372-382
    CrossrefPubMedGoogle Scholar
  • 14 Kişnişci RS, Işeri H, Tüz HH et al. Dentoalveolar distraction osteogenesis for rapid orthodontic canine retraction. J Oral Maxillofac Surg 2002; 60: 389-394
    CrossrefPubMedGoogle Scholar
  • 15 Kharkar VR, Kotrashetti SM, Kulkarni P. Comparative evaluation of dento-alveolar distraction and periodontal distraction assisted rapid retraction of the maxillary canine: a pilot study. Int J Oral Maxillofac Surg 2010; 39: 1074-1079
    CrossrefPubMedGoogle Scholar
  • 16 Bondemark L, Holm A, Hansen K et al. Long-term stability of orthodontic treatment and patient satisfaction. A systematic review. Angle Orthod 2007; 77: 181-191
    CrossrefPubMedGoogle Scholar
  • 17 Centre for Reviews and Dissemination . Systematic Reviews. CRD’s guidance for undertaking reviews in health care. 3rd (ed.) United Kingdom: Centre for Reviewa and Dissemination (CRD): University of York; 2009
    Google Scholar
  • 18 Higgins JPT, Altman DG, Sterne JAC. Assessing risk of bias in included studies. In: Higgins JPT, Green S. (eds.) Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0 [updated March 2011]. The Cochrane Collaboration 2011. Verfügbar unter www.cochrane-handbook.org Aufgerufen Februar 2014
    Google Scholar
  • 19 Ma WS, Dong FS, Ren GY et al. Rapid canine distalization through distraction of the periodontal ligament after reducing interseptal bone resistance. Zhonghua Kou Qiang Yi Xue Za Zhi 2008; 43: 546-550
    PubMedGoogle Scholar
  • 20 Kharkar VR, Kotrashetti SM. Transport dentoalveolar distraction osteogenesis-assisted rapid orthodontic canine retraction. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 109: 687-693
    CrossrefPubMedGoogle Scholar
  • 21 Shoreibah EA, Ibrahim SA, Attia MS et al. Clinical and radiographic evaluation of bone grafting in corticotomy-facilitated orthodontics in adults. J Int Acad Periodontol 2012; 14: 105-113
    Google Scholar
  • 22 Shoreibah EA, Salama AE, Attia MS et al. Corticotomy facilitated orthodontics in adults using a further modified technique. J Int Acad Periodontol 2012; 14: 97-104
    PubMedGoogle Scholar
  • 23 Gantes B, Rathbun E, Anholm M. Effects on the periodontium following corticotomy-facilitated orthodontics. Case reports. J Periodontol 1990; 61: 234-238
    Google Scholar
  • 24 Kişnişci RS, Işeri H. Dentoalveolar transport osteodistraction and canine distalization. J Oral Maxillofac Surg 2011; 69: 763-770
    CrossrefPubMedGoogle Scholar
  • 25 Sukurica Y, Karaman A, Gürel HG et al. Rapid canine distalization through segmental alveolar distraction osteogenesis. Angle Orthod 2007; 77: 226-236
    CrossrefPubMedGoogle Scholar
  • 26 Gurgan CA, Işeri H, Kişnişci R. Alterations in gingival dimensions following rapid canine retraction using dentoalveolar distraction osteogenesis. Eur J Orthod 2005; 27: 324-332
    CrossrefPubMedGoogle Scholar
  • 27 Işeri H, Kişnişci R, Bzizi N et al. Rapid canine retraction and orthodontic treatment with dentoalveolar distraction osteogenesis. Am J Orthod Dentofacial Orthop 2005; 127: 533-541
    CrossrefPubMedGoogle Scholar
  • 28 Mowafy MI, Zaher AR. Anchorage loss during canine retraction using intermittent versus continuous force distractions; a split mouth randomized clinical trial. Prog Orthod 2012; 13: 117-125
    CrossrefPubMedGoogle Scholar
  • 29 Kumar PS, Saxena R, Patil S et al. Clinical investigation of periodontal ligament distraction osteogenesis for rapid orthodontic canine retraction. Aust Orthod J 2009; 25: 147-152
    PubMedGoogle Scholar
  • 30 Sayin S, Bengi AO, Gürton AU et al. Rapid canine distalization using distraction of the periodontal ligament: a preliminary clinical validation of the original technique. Angle Orthod 2004; 74: 304-315
    PubMedGoogle Scholar
  • 31 Byloff-Clar H. Treatment with active plates with and without corticotomy in late cases (juveniles). A clinical and histological study. Stoma 1967; 20: 134-141
    PubMedGoogle Scholar
  • 32 Byloff-Clar H. Treatment with activator plates with and without corticotomy in late cases (juveniles). A clinical and histological study. Stoma 1967; 20: 214-225
    PubMedGoogle Scholar
  • 33 Byloff-Clar H. Treatment of delayed (juvenile) cases using activators with and without corticotomy. Clinical and histologic study. Stoma 1967; 20: 277-286
    PubMedGoogle Scholar
  • 34 Cassetta M, Di Carlo S, Giansanti M et al. The impact of osteotomy technique for corticotomy-assisted orthodontic treatment (CAOT) on oral health-related quality of life. Eur Rev Med Pharmacol Sci 2012; 16: 1735-1740
    PubMedGoogle Scholar
  • 35 Wilcko MT, Wilcko WM, Pulver JJ et al. Accelerated osteogenic orthodontics technique: a 1-stage surgically facilitated rapid orthodontic technique with alveolar augmentation. J Oral Maxillofac Surg 2009; 67: 2149-2159
    Google Scholar
  • 36 Ahn HW, Lee DY, Park YG et al. Accelerated decompensation of mandibular incisors in surgical skeletal Class III patients by using augmented corticotomy: a preliminary study. Am J Orthod Dentofacial Orthop 2012; 142: 199-206
    Google Scholar
  • 37 Nazarov AD, Ferguson DJ, Wilcko WM et al. Improved retention following corticotomy using ABO Objective Grading System. J Dent Res 2004; 83 abstract 2644
    PubMedGoogle Scholar
  • 38 Skountrianos HS, Ferguson DJ, Wilcko WM, Wilcko MT. Maxillary arch decrowding and stability with and without corticotomy-facilitated orthodontics. J Dent Res 2004; 83 abstract 2643
    PubMedGoogle Scholar
  • 39 Lee W, Karapetyan G, Moats R et al. Corticotomy-/osteotomy-assisted tooth movement microCTs differ. J Dent Res 2008; 8: 861-867
    PubMedGoogle Scholar
  • 40 Frost HM. The regional accelerated phenomenon. Orthop Clin N Am 1981; 12: 725-726
    PubMedGoogle Scholar
  • 41 Ferguson DJ, Wilcko WM, Wilcko MT. Selective alveolar decortication for rapid surgical-orthodontic resolution of skeletal malocclusion treatment. In: Bell WE, Guerrero CA. (eds.) Distraction Osteogenesis of the Facial Skeleton. B. C. Decker: Hamilton, Ontario; 2006: 199-203
    Google Scholar
  • 42 Yaffe A, Fine N, Binderman I. Regional accelerated phenomenon in the mandible following mucoperiosteal flap surgery. J Periodontol 1994; 65: 79-83
    Google Scholar
  • 43 Sebaoun JD, Kantarci A, Turner JW et al. Modeling of trabecular bone and lamina dura following selective alveolar decortication in rats. J Periodontol 2008; 79: 1679-1688
    Google Scholar
  • 44 Teixeira CC, Khoo E, Tran J et al. Cytokine expression and accelerated tooth movement. J Dent Res 2010; 89: 1135-1141
    Google Scholar
  • 45 Iglesias-Linares A, Yañez-Vico RM, Moreno-Fernandez AM et al. Corticotomy-assisted orthodontic enhancement by bone morphogenetic protein-2 administration. J Oral Maxillofac Surg 2012; 70: e124-e132
    CrossrefPubMedGoogle Scholar
  • 46 Baloul SS, Gerstenfeld LC, Morgan EF et al. Mechanism of action and morphologic changes in the alveolar bone in response to selective alveolar decortication-facilitated tooth movement. Am J Orthod Dentofacial Orthop 2011; 139: S83-S101
    Google Scholar