Zemann Wolfgang, Metzler Philipp, Jacobsen Christine, Obwegeser Joachim Anton
Department of Craniomaxillofacial and Oral Surgery, University of Zurich, Zurich, Switzerland.
J Oral Maxillofac Surg. 2012 Jun;70(6):1292-9. doi: 10.1016/j.joms.2011.12.007. Epub 2012 Feb 4.
Segmental distraction osteogenesis of the anterior alveolar process has been introduced as a technique designed to avoid extractions in patients with severe dental crowding. The aim of this study was to quantify the degree of dental tipping within the alveolar segment after distraction osteogenesis.
Patients treated for dental crowding, retruded anterior alveolar process, or flat curves of Spee using segmental distraction osteogenesis of the anterior alveolar process were included in the study. Dental-borne distraction devices were used while measuring points, and angles were defined to analyze the amount of dental tipping of the lower incisors after distraction. The measurements were performed using cone-beam computed tomographic scans. Periodontal health (eg, gingival recession, tooth mobility, and dental socket depths) was evaluated after distraction. A descriptive statistical analysis was performed.
Fifteen patients were included in the study. The amount of dental tipping within the total movement of the alveolar process showed a mean of 24% after distraction osteogenesis, whereas the skeletal movement was 76%. Dental socket depths and tooth mobility remained at the same levels as those before distraction osteogenesis. In one third of patients, gingival recession was observed around the canines.
Segmental distraction osteogenesis of the anterior process is a powerful technique that can prevent extractions in patients with dental crowding. The technique can also compensate for retruded anterior alveolar process and accelerate or decelerate the curve of Spee. Patients with constricted periodontal health and those with a thin mandibular symphysis, however, cannot be treated with this technique because of the increased risk of dental tipping. Severe gingival recession must also be considered a possible side effect associated with this technique.
前牙槽突节段性牵张成骨术已被引入，作为一种旨在避免严重牙列拥挤患者拔牙的技术。本研究的目的是量化牵张成骨术后牙槽突节段内牙齿倾斜的程度。
本研究纳入了采用前牙槽突节段性牵张成骨术治疗牙列拥挤、前牙槽突后缩或斯皮曲线平坦的患者。使用牙支持式牵张装置，同时定义测量点和角度，以分析牵张后下切牙的牙齿倾斜量。测量采用锥形束计算机断层扫描进行。牵张后评估牙周健康状况（如牙龈退缩、牙齿松动和牙槽窝深度）。进行描述性统计分析。
15例患者纳入本研究。牙槽突总移动中牙齿倾斜量在牵张成骨术后平均为24%，而骨移动为76%。牙槽窝深度和牙齿松动度与牵张成骨术前保持在相同水平。三分之一的患者在尖牙周围观察到牙龈退缩。
前牙槽突节段性牵张成骨术是一种有效的技术，可防止牙列拥挤患者拔牙。该技术还可补偿前牙槽突后缩，并加速或减缓斯皮曲线。然而，牙周健康受限的患者和下颌骨联合部较薄的患者，由于牙齿倾斜风险增加，不能采用该技术治疗。严重的牙龈退缩也必须被视为与该技术相关的一种可能的副作用。
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