Department of Periodontology, Peking University School and Hospital of Stomatology and National Center of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, China.
Fourth Clinical Division, Peking University School and Hospital of Stomatology and National Center of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Beijing, 100025, China.
Clin Oral Investig. 2024 Sep 17;28(10):529. doi: 10.1007/s00784-024-05805-0.
This study aims to investigate the changes in alveolar bone following the simultaneous performance of labial and lingual augmented corticotomy (LLAC) in patients with insufficient alveolar bone thickness on both the labial and lingual sides of the mandibular anterior teeth during presurgical orthodontic treatment.
Thirth-five surgical patients with skeletal Class III malocclusion were included: 19 (LLAC group) accepted LLAC surgery during presurgical orthodontic treatment, and 16 (non-surgery group, NS) accepted traditional presurgical orthodontic treatment. Cone-beam computed tomography (CBCT) scans were obtained before treatment (T0) and at the completion of presurgical orthodontic treatment (T1). The amount of vertical alveolar bone and contour area of the alveolar bone in the labial and lingual sides of mandibular incisors were measured.
After presurgical orthodontic treatment, the contour area of the alveolar bone at each level on the lingual side and alveolar bone level on both sides decreased significantly in the NS group (P < 0.001). However, the labial and lingual bone contour area at each level and bone level increased significantly in the LLAC group (P < 0.001). The bone formation rate in the lingual apical region was the highest, significantly different from other sites (P < 0.001).
During presurgical orthodontic treatment, LLAC can significantly increase the contour area of the labio-lingual alveolar bone in the mandibular anterior teeth to facilitate safe and effective orthodontic decompensation in skeletal Class III patients.
This surgery has positive clinical significance in patients lacking bone thickness (< 0.5 mm) in the labial and lingual sides of the lower incisors.
本研究旨在探讨在接受术前正畸治疗的下颌前牙唇舌侧骨量不足的患者中，同时进行唇侧和舌侧增强骨切开术（LLAC）后，牙槽骨的变化。
纳入 35 例骨骼 III 类错畸形患者：19 例（LLAC 组）在术前正畸治疗中接受 LLAC 手术，16 例（非手术组，NS）接受传统的术前正畸治疗。在治疗前（T0）和术前正畸治疗完成时（T1）获得锥形束 CT（CBCT）扫描。测量下颌切牙唇侧和舌侧牙槽骨的垂直牙槽骨量和牙槽骨轮廓面积。
在术前正畸治疗后，NS 组各水平的舌侧牙槽骨轮廓面积和牙槽骨水平显著减小（P<0.001）。然而，LLAC 组的唇侧和舌侧各水平牙槽骨轮廓面积和牙槽骨水平显著增加（P<0.001）。舌侧根尖区的成骨率最高，与其他部位有显著差异（P<0.001）。
在术前正畸治疗期间，LLAC 可显著增加下颌前牙唇舌侧牙槽骨的轮廓面积，有助于骨骼 III 类患者进行安全有效的正畸补偿。
对于下切牙唇舌侧骨量不足（<0.5mm）的患者，该手术具有积极的临床意义。
