加快正畸牙齿移动方法.pptVIP

In the current case report, the total orthodontic treat-ment time (16 months) was dramatically reduced whencompared with the average treatment time for extrac-tion therapy (31 months). In corticotomy-facilitatedorthodontics, the reduction of orthodontic treatmenttime by approximately 50% was observed. CLINICAL EVIDENCE CLINICAL EVIDENCE CLINICAL EVIDENCE CLINICAL EVIDENCE The perimeter was defined by tracing the labiolingual centers of each tooth from canine to canine. CLINICAL EVIDENCE CLINICAL EVIDENCE CLINICAL EVIDENCE CLINICAL EVIDENCE CLINICAL EVIDENCE CLINICAL EVIDENCE The results of the randomized controlled clinical trial demonstrate that AcceleDent can increase the rate of tooth movement when used in conjunction with conventional orthodontics. Use of AcceleDent did not increase the risk of either root resorption CASE REPORT 18 year old male Class III combination ortho surgical case CASE REPORT CASE REPORT 9 Weeks CASE REPORT 5 days post orthognathic surgery (9 months into treatment 2 months of delay with travels and parents away) CASE REPORT 6.5 weeks post surgery 46 Weeks Total Treatment Time corticotomy-assisted orthodontic treatment (CAOT) 发展过程 1893年Bryan 提出骨皮质切开加速牙齿移动这一概念。 1959年Kole等首先应用了骨皮质首先应用了骨皮质切开术结合根尖下截骨术，证实能够有效加快正畸牙齿的移动。 2001年Wilcko等提出了牙周加速成骨正畸(periodontally accelerated osteogenic orthodontics, PAOO ) 的新理念，主要通过切开正畸牙牙根周围颊侧骨皮质至骨髓质深度，并在切开骨表面放置可吸收人工骨材料以增加骨量。 理论基础 骨块移动理论（bone block theory）：颌骨骨皮质切开加速正畸牙齿移动的理论基础早期在手术中于牙齿近远中颊舌侧骨板进行骨皮质切开，保留骨松质的连续性，通过根尖下截骨术连接骨皮质切口以形成完整牙骨块， 他认为去除骨皮质阻力后，牙齿与周围骨块形成整体在正畸力作用下加速移动，即为骨块移动理论。 理论基础 局部骨加速现象（regional acceleratory phenomenond RAP ）被认为是骨皮质切开术加速牙齿移动的根本原因，而不是骨块移动理论。 理论基础 局部骨加速现象（regional acceleratory phenomenond RAP ）为术后局部骨质产生的暂时性脱矿与再矿化 表现为: 在骨组织创伤后术创附近的牙槽骨进入短暂可逆的骨质减少状态，骨吸收及溶骨现象随即出现; 在这一分解代谢的过程中骨密度虽然降低，但牙槽骨骨量并没有减少; 正畸力施加使得牙根周围骨基质及骨胶原软组织基质随之移动; 在随后的再矿化过程中新骨沉积，类骨质基质再矿化，重新包绕牙根周围。 骨皮质切开术后一段时间可以加快正畸牙齿移动的速度，而该过程是基于引发现象后牙槽骨吸收和重建过程（RAP）. 临床应用 解除拥挤 矫正上前牙唇倾，加速前牙内收，改善前突面型 骨性 三类错合畸形下前牙舌倾的去代偿 个