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JOURNAL CLUB INDIAN DENTAL ACADEMY Leader in continuing dental education


AO 2006,76(6);880-88


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SURGERY – combined for better ortho Tx CORTICOTOMY RAP AOO


“ Surgical removal of alveo bone “ OR Osteotomy of the cortical bon

It distract the bone – growth of new bone

Moving group of teeth with alveo processspongiosa intact

Review of literature   

1950 Periodontists - rate of OTM 1959 Kole – 1st labial & palatal corticotomy 1990 Dr.Wilcko: AOO - (CT scan) mineralisation of alveolar bone – responsible for OTM 2001 chung et al- ant retraction in bimax


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Alternative to ortho Tx FASTER, less side effects & pt compliance Moving blocks of bone ORTHO Tx TIME – resistance of the dense cortical bone to OTM is removed


Non-growing / Old / faster ortho Tx

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

Advantages rate of OTM – Tx time  Avoid adverse effects of ortho Tx :  No gingival/PDL damage  Root resorption  Loss of vitality of teeth/bone  Conservative surgery  No retention problems & tongue functions – after Tx 

Conventional :  Both B-L cuts 

2 stage surgery

Modified :  LABIAL- only no lingual V & sub apical H/Z cuts  Conservative – 1stge Less time & pt discomfort  Corticotomy sitemobilised

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

Tx objectives: Tx plan :  X of al 4s-maxi anchorage  Segmental canine retraction-at end accelaration by – corticotomyfacilitated incisor retraction

Pre op – OPG,OCCLUSAL Retraction-0.016 x 0.022 S.S with T loop-1wk b4

SURGERY : ď Ž 0.5mm S.S bur, 1.5-2mm depth, 2-3mm below apices

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Immediate consolidation 3 wks- Dec OJ, Xn space closed LI retraction - 1.5 mos No problems of vascularity/vitality/root resoption/gingival

Results 

Correction of pt problem list Tx completion – 16 mos

Conclusion 

Effective alternative Tx – adults,sevre malocclusion, the Tx time (50%) Beneficial- in difficult surgical lingual accessibility Modified CORTI- coservative, less time & pt discomfort, cost effective Risk of tissue damage- teeth,bone,PDL

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