正畸治疗时牙齿移动引起的骨开裂.pptVIP

The phenomenon of bone dehiscences Definition anterior tooth movement exceeds bony apposition can lead to resorption of the cortical bone and exposure of the root High-risk population mandible maxilla protrusion expansion of the maxillary arch Example 1 Location of bone-thickness measurements before and after retraction S1 S2 S3 Example 2 rotated canines and crowding of the incisors are found in the pretherapeutic mandibular situation corresponding pretreatment CT examination：3D-reconstruction narrow frontal mandibular alveolarprocess with thin facial bone plates Clinical situation after two years of orthodontic treatment Corresponding CT examination： 3D-reconstruction extensive facial dehiscences above the roots of the incisors and canines Dental anatomy Alveolar bone proper Supporting alveolar bone Cortical plate Spongy bone bone traces tooth movement? A basic axiom in orthodontics is whenever orthodontic tooth movement occurs, bone around the alveolar socket will remodel to the same extent The truth is… In the vertical dimension: during orthodontic tooth extrusion, bone increase is usually less than the dental displacement, leading to an increase in the clinical crown. In the transverse dimension: bone remodeling/tooth movement ratio of tooth retraction with tip and with torque is 1:2 and 1:2.35 respectively Repair of the perforation site bone dehiscences were partly repaired in the retention period, but it was insufficient to cover the root completely Repair of the perforation site will lead to relapse of the teeth conclusion retraction of the incisors is limited forcing the tooth against the cortical bone may cause adverse sequelae surgical orthodontic treatment should be taked when tooth movement exceed “bone wall” anterior maxillary subapical osteotomy initial examination before surgery：maxillary first premolars and left mandibular central incisor were extracted. All residual third molar