骨皮质切开术及改良术式加速正畸牙移动的临床研究进展

Clinical research progress on corticotomy and modified techniques for accelerating orthodontic tooth movement

摘要

加速正畸牙移动的辅助干预技术一直是正畸领域关注的热点。较长的正畸治疗周期常伴随多种潜在并发症，例如脱矿、龋坏、牙根吸收和牙龈炎症等。因此，使用加速正畸牙移动的辅助干预技术，缩短正畸治疗周期，可以为患者提供诸多益处，具有重要的临床意义。目前，加速正畸牙移动的辅助干预措施主要可以分为手术干预和非手术干预。其中，手术干预又以骨皮质切开术及其改良术式在临床最为常见，可以显著减少治疗时间，实现牙槽骨增量，扩大牙移动范围，但是会不可避免地造成创伤，存在诸多风险及限制因素，因而未能在临床上得到广泛应用。近年来，多种骨皮质切开术的改良术式不断涌现，如微创骨皮质切开术、压电切开术、骨微穿孔术和盘状切开术等，有效减少了软、硬组织损伤，降低了术后并发症发生率，且临床操作较为简便。皮质切开及改良术式均能在一定程度上缩短正畸治疗的时间，并对牙周健康的恢复有促进作用，且其对牙周、牙体及牙髓组织不会造成不利影响，但是在临床应用时仍需要对牙周组织损伤、牙根吸收、牙髓活力丧失等潜在副作用及不足进行重点关注和长期随访。

Abstract

Adjunctive interventions for accelerating orthodontic tooth movement have been a hot topic of interest in orthodontics. Prolonged orthodontic treatment is often associated with multiple potential complications, such as decalcification, caries, root resorption, and gingival inflammation. Therefore, applying adjunctive interventions that accelerate orthodontic tooth movement and reduce the duration of orthodontic treatment can provide patients with numerous benefits that are of profound clinical significance. Currently, adjunctive interventions for accelerating orthodontic tooth movement can be divided into two main categories: surgical and nonsurgical. Surgical interventions, represented by corticotomy and modified corticotomy procedures, are the most common in clinical practice and can minimize the treatment duration, augment alveolar bone, and expand the range of orthodontic tooth movement. However, these procedures are inevitably traumatic and have many risks and limitations that prevent them from being widely used in clinical practice. In recent years, multiple modified corticotomy techniques, such as corticision, piezocision, micro-osteoperforation, and discision, have been proposed; these techniques can reduce soft and hard tissue damage and the incidence of postoperative complications and are relatively easy to perform in the clinic. Corticotomy and other improved surgical techniques can shorten the duration of orthodontic treatment to a certain extent and promote the recovery of periodontal health with no adverse effects on periodontal, dental, or pulp tissues. However, in clinical application, several potential side effects (such as periodontal tissue damage, root resorption, loss of pulp vitality, etc) and shortcomings need further research with long-term follow-up.

关键词

正畸 / 骨皮质切开术 / 加速 / 正畸牙移动 / 局部加速现象 / 牙槽骨改建 / 牙周加速成骨正畸 / 牙根吸收

Key words

orthodontic / corticotomy / acceleration / orthodontic tooth movement / regional acceleratory phenomenon / alveolar bone reconstruction / periodontal accelerated osteogenesis orthodontic / root resorption

Author summay

钟恺靖，本科，学士，Email：[e-mail]