Rapid canine distal movement through distraction osteogenesis of the periodontal ligament

doi:10.3969/j.issn.2095-4344.2013.41.011

Abstract

Abstract:

BACKGROUND: Distraction osteogenesis applied in patient’s canine distal movement, can greatly improve the speed of tooth movement, and protect the molar anchorage. But the researches on the traction rate, canine pulp vitality, canine periodontal tissue remodeling and the biological mechanisms of the technology are rare recently.
OBJECTIVE: To evaluate the feasibility of rapid canine retraction through distraction osteogenesis of the periodontal ligament in adult patients and to monitor the pulp vitality, root resorption and periodontal remodeling of the canine.
METHODS: Nine malocclusion patients were selected, and the bilateral maxillary canine in adult patients were rapidly retracted and moved to the scheduled position using modified distraction devices. The canine distal movement distance, anchorage loss, root resorption and alveolar interval alterations were measured through intraoral radiographs, and lateral cephalograms. The pulp and periodontal of canine were mointrored.
RESULTS AND CONCLUSION: The canines could be rapidly retracted to the schedualed position through distraction osteogenesis of the periodontal ligament in 12-16 days, the average amount of retraction was 7.18 mm and the canines tipped distally (13.24±2.87)°. The anchorage loss was 0.5 mm. There was no obvious root resorption and periodontal tissue loss. The pulp vitality of the canines was decreased significantly right after distraction, but it recovered significantly after 3 months. The results indicated that periodontal ligament distraction osteogenesis can significantly accelerate canine movement speed, shorten treatment time, while protecting the molar anchorage; there was no significant adverse reaction of root resorption, loose teeth, pulp necrosis and loss of periodontal tissue. Indcating that distraction osteogenesis of periodontal ligament can move canines rapidly and effectively.

Key words: orthodontic extrusion, orthodotics, corrective, cuspid, periodontal ligamtent

CLC Number:

R318

Mai Zhi-hui, Zhang Jing-lan, Lu Hong-fei, Chen Qi, Liang Huang-you, Ai Hong. Rapid canine distal movement through distraction osteogenesis of the periodontal ligament[J]. Chinese Journal of Tissue Engineering Research, 2013, 17(41): 7255-7264.

Figures/Tables 6

Root resorption Root resorption of the canines was minimal. After distraction, apical root resorption of S1 occurred in 2/18 of the canines, while rdiographic examination showed no evidence of complications, such as root fracture and ankylosis in all teeth (canines, incisors, second premolars, ?rst molars), in any patient. No apical or lateral root resorption (S0) was detected in any subject at T1, T2 and T3. Remodeling of the canine periodontal tissues Newly formed alveolar bone in mesial canines was matured at 3 months after distraction. The periapical radiographs showed a process from empty to solid in the mesial distraction space of canine. One week after canine distraction (Figure 4C), the mesial periodontal space was widened (the space of cervical area was wider than the apical area), showing low density, and the original lamina dura turned indistinct, while the distal lamina dura remained clear. The alveolar fossa was significantly narrowed because of pressure and showed no significant increase of density. No obvious fracture line was found in distal alveolar bone of canine. At the end of the canine distraction (Figure 4E), the mesial periodontal space of canine became obvious, with a triangle-shaped opening towards the gingival margin. The lamina dura was invisible. Low-density was showed in the apical area of canine. Distal periodontal space was widened and the lamina dura disappeared. The alveolar fossa was significantly narrower than before, but the boundary was still clear. The density of alveolar fossa was higher than that in the first week of distraction. Obvious deformation caused by pressure was found in the distal interval alveolar bone of the canine. The boundary of the alveolar crest was indistinct, and the height of it was decreased by about 1 mm. A low-density shadow was found in the lower 1/3 of the interval alveolar bone, which was considered to be a fracture line. One month after placement of fixed appliance (Figure 4F), the mesial space of canine was still empty, but the density was higher than that in the first two weeks. The density around the canine root was significantly increased, but no obvious formation of lamina dura was found. The boundary of alveolar fossa was still indistinct. The density of alveolar fossa was high, but still lower than normal. The periodontal space of canine was still clear. Oblique resorption was found in the alveolar crest, and the height of it was decreased by about 1.5 mm. Three months after placement of fixed appliance (Figure 4G), the width of periodontal space of canine returned to normal, with a clear lamina dura. The height of interval alveolar bone returned to the level before distraction; while the density of neonatal mesial interval alveolar bone was slightly lower (Figure 5)."

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