Kim Berna, Dreyer Craig W, Sampson Wayne
Orthodontic Unit, The University Adelaide, South Australia, Australia.
Aust Orthod J. 2014 Nov;30(2):201-7.
There has been a revival of interest in the acceleration of orthodontic tooth movement (OTM) by inducing injury to dentoalveolar cortical bone. Termed corticotomy, the procedure offers an advantage to adult patients whose bone metabolism is such that any reduction in treatment time would be welcomed. The procedure has been refined for over 100 years and recent research indicates treatment duration may be reduced often by as much as a third, but it is not clear how widely the method is applied in practice. For the procedure to be successful, careful interdisciplinary management by orthodontists and periodontists is required. However, information regarding the attitude and knowledge of practitioners and the frequency of the procedure performed in Australia and New Zealand is lacking.
A questionnaire was formulated and tested in a pilot study on postgraduate orthodontic and periodontic students at The University of Adelaide. As a consequence of the responses, the wording of several questions was clarified and the sequence modified to produce the final format. Separate questionnaires were developed for specialist orthodontists and periodontists in keeping with their different backgrounds and were distributed at two relevant conferences.
The number of practitioners who had been involved with at least one corticotomy per annum was low for orthodontists (12%) and periodontists (18%). The majority of those surveyed believed that more research was required on corticotomy-facilitated OTM and would not recommend the procedure to patients without greater investigation of the technique. More than half of the sampled orthodontists indicated that they would never recommend corticotomy-facilitated orthodontics to their patients. The minority who were willing to recommend the procedure would limit involvement to adult patients, the management of ankylosed teeth, impacted canines and patients susceptible to root resorption. Over 90% of the sampled periodontists believed that there were adverse side effects.
通过对牙槽骨皮质骨造成损伤来加速正畸牙齿移动（OTM）重新引起了人们的关注。这种被称为皮质切开术的方法，对于骨代谢使得治疗时间的任何缩短都备受欢迎的成年患者具有优势。该手术已经改进了100多年，最近的研究表明治疗时间通常可减少多达三分之一，但尚不清楚该方法在实际应用中的广泛程度。为使该手术成功，正畸医生和牙周病医生需要进行仔细的多学科管理。然而，关于澳大利亚和新西兰从业者的态度和知识以及该手术的实施频率的信息却很缺乏。
设计了一份问卷，并在阿德莱德大学对正畸和牙周专业研究生进行的一项试点研究中进行了测试。根据反馈，对几个问题的措辞进行了澄清，并修改了顺序以形成最终版本。针对正畸专科医生和牙周专科医生，根据他们不同的背景分别制定了问卷，并在两个相关会议上进行了分发。
每年至少参与一次皮质切开术的正畸医生（12%）和牙周病医生（18%）的人数较少。大多数受访者认为，对于皮质切开术辅助的OTM需要进行更多研究，并且在对该技术进行更深入调查之前，不会向患者推荐该手术。超过一半的抽样正畸医生表示，他们永远不会向患者推荐皮质切开术辅助的正畸治疗。少数愿意推荐该手术的医生会将参与范围限制在成年患者、粘连牙的处理、阻生犬齿以及易发生牙根吸收的患者。超过90%的抽样牙周病医生认为存在不良副作用。
