Int J Periodontics Restorative Dent. 2021 Jan-Feb;41(1):105-111. doi: 10.11607/prd.4562.
Orthodontic therapy could lead to marginal bone resorption in cases where the teeth are moved outside the envelope of bone. The purpose of this case series was to test corticotomy with a guided bone regeneration (GBR) procedure to regenerate bone in the direction of movement outside the original bony housing. Ten adult patients (60 anterior teeth), all presenting with severe anterior crowding, were enrolled in the study. Orthodontic therapy in all investigated sites was associated with selective surgical corticotomies and a simultaneous GBR procedure. CBCT examinations were performed before starting orthodontic treatment (T0) and at the end of treatment (T1; mean: 7 months; range: 6 to 9 months). Pre- and postoperative CBCTs were superimposed with a DICOM viewer (3D Slicer) and studied with an image-processing software (ImageJ, National Institutes of Health) to measure the area of interest of the buccal plate. The average area was found to be 0.58 ± 0.22 mm at T0 and 1.76 ± 0.4 mm at T1, with a statistically significant difference (P < .05). The combination of corticotomy and a regenerative procedure seems to have the ability to augment the original osseous anatomy when the root is moved outside of the original bony envelope.
正畸治疗可导致牙齿在骨袋外移动时出现边缘骨吸收。本病例系列研究的目的是测试皮质切开术联合引导骨再生（GBR）程序，以在原始骨壳外的移动方向上再生骨。本研究纳入了 10 名成人患者（60 颗前牙），所有患者均表现出严重的前牙拥挤。所有研究部位的正畸治疗均伴有选择性外科皮质切开术和同期 GBR 手术。在开始正畸治疗前（T0）和治疗结束时（T1；平均：7 个月；范围：6 至 9 个月）进行 CBCT 检查。使用 DICOM 查看器（3D Slicer）对术前和术后 CBCT 进行叠加，并使用图像处理软件（ImageJ，美国国立卫生研究院）对感兴趣的颊板区域进行研究，以测量该区域。结果发现，T0 时的平均面积为 0.58 ± 0.22mm，T1 时为 1.76 ± 0.4mm，差异有统计学意义（P<0.05）。当牙根移出原始骨袋时，皮质切开术联合再生程序似乎有能力增加原始骨解剖结构。
