The Angle Orthodontist.doc - The Angle Orthodontist Vol 76...

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The Angle Orthodontist: Vol. 76, No. 5, pp. 882–890. Lower Incisor Retraction with a Modified Corticotomy Derya Germeç; a Bahadir Giray; b Ilken Kocadereli; c Ayhan Enacar† d ABSTRACT This case report demonstrates the orthodontic treatment facilitated with a new conservative corticotomy technique to shorten the treatment time during lower incisor retraction. The patient was a 22-year-old woman with protrusive profile, severe anterior crowding, an anterior crossbite, and Class III dental relationship. Orthodontic treatment consisted of the extraction of four first premolars with maximum anchorage. A modified corticotomy technique, in which the lingual vertical and subapical horizontal cuts were eliminated, was combined with orthodontic therapy for the retraction of the lower anterior teeth. Corticotomy-facilitated orthodontics dramatically reduced the treatment time without any adverse effects on the periodontium and the vitality of the teeth. The main advantages of this modified corticotomy technique were the elimination of the lingual cuts and flap, the reduction of surgery time, and minimum discomfort to the patient. At the end of active orthodontic therapy, balanced occlusion and facial esthetics were achieved. KEY WORDS: Modified corticotomy, Incisor retraction, Treatment time, Adult. Accepted: November 2005. Submitted: July 2005 INTRODUCTION Return to TOC Many surgical procedures have been combined with conventional orthodontics for better treatment of severe dentoalveolar abnormalities. Among these procedures, surgical alveolar corticotomies have been used for years in correction of malocclusions. Corticotomy is defined as the osteotomy of the cortical bone. 1 In adult patients, this technique dramatically reduces the treatment time because the resistance of the dense cortical bone to orthodontic tooth movement is removed. 1–4 Also, corticotomy-facilitated orthodontics enables the limitation of the undesirable adverse effects of the orthodontic therapy, such as root resorption and periodontal damage. 5 The alveolar corticotomy technique has been revised and changed over the years 1, 2, 5 to eliminate possible risks of the procedure, such as periodontal damage and devitalization of the teeth and osseous segments because of inadequate blood supply. The aim of this report is to present the rapid and effective modified alveolar corticotomy-facilitated orthodontic treatment of an adult case with severe malocclusion. CASE REPORT Return to TOC Diagnosis and Etiology A 22-year-old Vietnamese female patient with a chief complaint of severe anterior crowding showed a protrusive facial profile ( Figure 1A–C ). The oral hygiene was not adequate in the anterior region because of the irregularity. Her intraoral examination revealed 3.5 mm of diastema between maxillary incisors caused by a recently extracted mesiodens, Angle Class III canine relationship, and anterior crossbite. The maxillary and mandibular crowding were −8 mm and −6 mm. Deviation of upper and lower midlines was noted. Slight gingival recession was detected in the labially positioned left lower central incisor ( Figures 2A–E and 3A–E ).

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