Tiefengraber Julia, Diedrich Peter, Fritz Ulrike, Lantos Peter
Department of Orthodontics, University of Aachen, Germany.
J Orofac Orthop. 2002 Sep;63(5):422-8. doi: 10.1007/s00056-002-0126-1.
In periodontology and implantology the guided bone regeneration (GBR) technique represents a well established and successful method for augmentation of alveolar bone. The aim of the present study was to evaluate what advantages, if any, are offered for orthodontic space closure by membrane supported healing of extraction sockets (MHE) (criteria: rate of movement, incidence of gingival clefts, atrophy of the alveolar bone).
Within the scope of orthodontic therapy with a complete fixed appliance, three girls aged 11-14 years with indication for extraction of the first premolars were unilaterally augmented with an e-PTFE membrane (Gore-Tex((R)), W. L. Gore & Associates, Flagstaff, AZ, USA) immediately after premolar extraction. The study was performed in the split-mouth technique. An atraumatic extraction without digital compression was performed on the control side. The membranes were fixed with a Frios((R)) fixation set (Friadent, GmbH, Mannheim, Germany) and removed after 6 to 8 weeks. 1 week after membrane removal, space closure was started simultaneously with passive rectangular segmented archwires using Sentalloy((R)) closed coil springs (GAC International, Inc., Gräfelfing, Germany) at a constant force of 200 cN. The transversal and vertical dimensions of the alveolar bone the rate of space closure were determined clinically and radiographically.
Complications were not observed in any patient. The MHE-treated alveolar region showed pronounced stability of the transversal dimension. Space closure was performed in all cases without gingival clefts being induced. The control side showed distinct atrophy as well as gingival clefts. No differences were recorded in the rate of space closure.
The MHE technique seems to be a suitable means of creating favorable periodontal conditions for tooth movement, especially in cases of alveolar bone loss after extraction or trauma.
在牙周病学和种植学中，引导骨再生（GBR）技术是一种成熟且成功的牙槽骨增量方法。本研究的目的是评估通过拔牙窝的膜支持愈合（MHE）进行正畸间隙关闭有哪些优势（如有）（标准：移动速率、牙龈裂发生率、牙槽骨萎缩情况）。
在使用完整固定矫治器进行正畸治疗的过程中，3名年龄在11 - 14岁、有拔除第一前磨牙指征的女孩在拔除前磨牙后立即在一侧使用e - PTFE膜（Gore - Tex((R))，W. L. Gore & Associates，美国亚利桑那州弗拉格斯塔夫）进行单侧增量。研究采用分侧对照技术。对照侧进行无指压的无创拔牙。使用Frios((R))固定装置（Friadent，GmbH，德国曼海姆）固定膜，6至8周后取出。取出膜1周后，使用Sentalloy((R))闭合螺旋弹簧（GAC International，Inc.，德国格拉费林）以200 cN的恒定力，同时使用被动矩形分段弓丝开始间隙关闭。通过临床和影像学方法确定牙槽骨的横向和垂直尺寸以及间隙关闭速率。
所有患者均未观察到并发症。MHE治疗的牙槽区域横向尺寸显示出明显的稳定性。所有病例均成功关闭间隙，未诱发牙龈裂。对照侧出现明显萎缩以及牙龈裂。间隙关闭速率未记录到差异。
MHE技术似乎是为牙齿移动创造有利牙周条件的合适方法，特别是在拔牙或外伤后牙槽骨丧失的情况下。
