国际口腔医学杂志 ›› 2023, Vol. 50 ›› Issue (2): 243-250.doi: 10.7518/gjkq.2023025

• 综述 • 上一篇    

骨增量技术在口腔正畸领域的研究进展

蒋青松(),赖文莉,王艳()   

  1. 口腔疾病研究国家重点实验室 国家口腔疾病临床医学研究中心四川大学华西口腔医院正畸科 成都 610041
  • 收稿日期:2022-06-23 修回日期:2022-10-27 出版日期:2023-03-01 发布日期:2023-03-14
  • 通讯作者: 王艳
  • 作者简介:蒋青松,硕士,Email:Jyangqs@163.com
  • 基金资助:
    国家自然科学基金(82071147);爱齐国际研究奖金项目(19H0637);时代天使隐形矫治科研专项基金(21H0900)

Research progress on bone augmentation technique in orthodontics

Jiang Qingsong(),Lai Wenli,Wang Yan.()   

  1. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2022-06-23 Revised:2022-10-27 Online:2023-03-01 Published:2023-03-14
  • Contact: Yan. Wang
  • Supported by:
    National Natural Science Foundation of China(82071147);International Align Research Award Program(19H0637);Angelalign Clear Aligner Treatment Specialized Scientific Research Fund(21H0900)

摘要:

正畸患者常常表现出牙槽骨量不足,这会增大正畸过程中骨开窗、骨开裂及牙根吸收等并发症的风险。因此,口腔医生应充分评估患者的牙槽骨状况,及时制定和实施骨增量方案。目前,牙周加速成骨正畸、引导性骨再生以及位点保存术等技术已经用于正畸患者的牙槽骨增量。通过制定和实施合理的骨增量方案,能够减少正畸治疗的并发症,增大牙移动范围,拓宽正畸治疗的适应证,提高矫治效果的稳定性。本文就牙槽骨增量技术的机制、适应证、时机、骨增量效果和并发症作一综述。

关键词: 骨增量, 正畸, 牙周加速成骨正畸, 引导性骨再生, 位点保存术

Abstract:

Orthodontic patients often exhibit insufficient alveolar bone volumes, such as dehiscence, fenestration, and root resorption, which will increase the risk of complications during orthodontic treatment. Therefore, dentists should adequately evaluate the alveolar bone of patients to formulate and implement bone augmentation plans in time. At present, periodontally accelerated osteogenic orthodontics, guided bone regeneration, and site preservation techniques have been used for the alveolar bone augmentation of orthodontic patients. Moreover, the development and implementation of a reasonable bone augmentation program can reduce the complications of orthodontic treatment, increase the range of tooth movement, broaden the indications of orthodontic treatment, and improve the stability of the orthodontic effect. Therefore, this review summarizes the mechanism, indications, timing, effects, and complications of alveolar bone augmentation techniques.

Key words: bone augmentation, orthodontics, periodontally accelerated osteogenic orthodontics, guided born rege-neration, site preservation

中图分类号: 

  • R 783.5
1 周琳, 李巍然. 锥形束CT在评价双颌前突患者前牙区牙槽骨缺损中的应用[J]. 北京大学学报(医学版), 2015, 47(3): 514-520.
Zhou L, Li WR. Evaluation of alveolar bone defects on anterior region in patients with bimaxillary protrusion by using cone-beam CT[J]. J Peking Univ (Health Sci), 2015, 47(3): 514-520.
2 Choi JY, Chaudhry K, Parks E, et al. Prevalence of posterior alveolar bony dehiscence and fenestration in adults with posterior crossbite: a CBCT study[J]. Prog Orthod, 2020, 21(1): 8.
3 赵欢, 刘琳. 牙槽骨缺损与正畸诊疗研究进展[J]. 中国实用口腔科杂志, 2016, 9(10): 624-627.
Zhao H, Liu L. Study on alveolar bone defects in orthodontic diagnosis and treatment[J]. Chin J Pract Stomatol, 2016, 9(10): 624-627.
4 Vannala V, Katta A, Reddy MS, et al. Periodontal accelerated osteogenic orthodontics technique for ra-pid orthodontic tooth movement: a systematic review[J]. J Pharm Bioallied Sci, 2019, 11(): S97-S106.
5 Keser E, Naini FB. Accelerated orthodontic tooth movement: surgical techniques and the regional acceleratory phenomenon[J]. Maxillofac Plast Reconstr Surg, 2022, 44(1): 1.
6 Klein Y, Kunthawong N, Fleissig O, et al. The impact of alloplast and allograft on bone homeostasis: orthodontic tooth movement into regenerated bone[J]. J Periodontol, 2020, 91(8): 1067-1075.
7 Ru N, Liu SS, Bai YX, et al. BoneCeramic graft regenerates alveolar defects but slows orthodontic tooth movement with less root resorption[J]. Am J Orthod Dentofacial Orthop, 2016, 149(4): 523-532.
8 Sheats RD, Strauss RA, Rubenstein LK. Effect of a resorbable bone graft material on orthodontic tooth movement through surgical defects in the cat mandible[J]. J Oral Maxillofac Surg, 1991, 49(12): 1299-1304.
9 Araújo MG, Carmagnola D, Berglundh T, et al. Orthodontic movement in bone defects augmented with Bio-Oss. An experimental study in dogs[J]. J Clin Periodontol, 2008, 28(1): 73-80.
10 Miyamoto T, Lang M, Khan S, et al. The clinical efficacy of deproteinized bovine bone mineral with 10% collagen in conjunction with localized piezosurgical decortication enhanced orthodontics: a prospective observational study[J]. J Periodontol, 2019, 90(10): 1106-1115.
11 Jing WD, Jiao J, Xu L, et al. Periodontal soft- and hard-tissue changes after augmented corticotomy in Chinese adult patients with skeletal Angle Class Ⅲ malocclusion: a non-randomized controlled trial[J]. J Periodontol, 2020, 91(11): 1419-1428.
12 Nowzari H, Yorita FK, Chang HC. Periodontally accelerated osteogenic orthodontics combined with autogenous bone grafting[J]. Compend Contin Educ Dent, 2008, 29(4): 200-207, 218.
13 Wilcko MT, Wilcko WM, Pulver JJ, et al. Accelera-ted osteogenic orthodontics technique: a 1-stage surgically facilitated rapid orthodontic technique with alveolar augmentation[J]. J Oral Maxillofac Surg, 2009, 67(10): 2149-2159.
14 Alsayegh E, Balut N, Ferguson DJ, et al. Maxillary expansion: a comparison of Damon self-ligating bracket therapy with MARPE and PAOO[J]. Biomed Res Int, 2022, 2022: 1974467.
15 Amit G, Jps K, Pankaj B, et al. Periodontally acce-lerated osteogenic orthodontics (PAOO)-a review[J]. J Clin Exp Dent, 2012, 4(5): e292-e296.
16 Donald JF, Machado I, Wilcko MT, et al. Root resorption following periodontally accelerated osteogenic orthodontics[J]. APOS Trends Orthod, 2016, 6: 78-84.
17 谢玉峰. 牙周辅助加速成骨正畸在临床治疗中的应用[J]. 中华口腔医学杂志, 2021, 56(10): 978-982.
Xie YF. Periodontally accelerated osteogenic orthodontics in clinical treatment[J]. Chin J Stomatol, 2021, 56(10): 978-982.
18 Coşkun İ, Kaya B. Appraisal of the relationship between tooth inclination, dehiscence, fenestration, and sagittal skeletal pattern with cone beam compu-ted tomography[J]. Angle Orthod, 2019, 89(4): 544-551.
19 Jiao J, Jing WD, Hou JX, et al. Nomogram prediction of vulnerable periodontal condition before or-thodontic treatment in the anterior teeth of Chinese patients with skeletal Class Ⅲ malocclusion[J]. Acta Odontol Scand, 2021, 79(7): 536-544.
20 Gao J, Nguyen T, Oberoi S, et al. The significance of utilizing A corticotomy on periodontal and ortho-dontic outcomes: a systematic review and meta-analysis[J]. Biology (Basel), 2021, 10(8): 803.
21 Yagci A, Veli I, Uysal T, et al. Dehiscence and fenestration in skeletal Class Ⅰ, Ⅱ, and Ⅲ malocclusions assessed with cone-beam computed tomography[J]. Angle Orthod, 2012, 82(1): 67-74.
22 Pereira-Stabile CL, Ochs MW, de Moraes M, et al. Preoperative incisor inclination in patients with Class Ⅲ dentofacial deformities treated with orthognathic surgery[J]. Br J Oral Maxillofac Surg, 2012, 50(6): 533-536.
23 Xu X, Wu JQ, Jiang JH, et al. Periodontal effect of periodontally accelerated osteogenic orthodontics in skeletal Angle Class Ⅲ: a nonrandomized, controlled trial[J]. Int J Periodontics Restorative Dent, 2020, 40(4): e169-e177.
24 Kantharaju V, Shivamurthy R, Shamanna P. Perio-dontally accelerated osteogenic orthodontics: a boon in a severe periodontally compromised Class Ⅱ division 1 malocclusion patient[J]. Int J Orthod Rehabil, 2019, 10(1): 53-56.
25 Bahammam MA. Effectiveness of bovine-derived xenograft versus bioactive glass with periodontally accelerated osteogenic orthodontics in adults: a randomized, controlled clinical trial[J]. BMC Oral Health, 2016, 16(1): 126.
26 Mandelaris GA, Richman C, Kao RT. Surgical considerations and decision making in surgically facilitated orthodontic treatment/periodontally accelera-ted osteogenic orthodontics[J]. Clin Adv Periodontics, 2020, 10(4): 213-223.
27 Venugopalan V, Vamsi AR, Shenoy S, et al. Guided bone regeneration-a comprehensive review[J]. J Clin Diag Res, 2021, 15(4). doi: 10.7860/JCDR/2021/ 47728.14714 .
doi: 10.7860/JCDR/2021/ 47728.14714
28 Petre A, Balta C, Herman H, et al. A novel experimental approach to evaluate guided bone regeneration (GBR) in the rat femur using a 3D-printed CAD/CAM zirconia space-maintaining barrier[J]. J Adv Res, 2021, 28: 221-229.
29 陈露祎, 黄忞, 吴佳奇, 等. 引导骨再生术辅助正畸治疗关闭中切牙缺牙间隙的应用[J]. 华西口腔医学杂志, 2021, 39(4): 482-488.
Chen LY, Huang M, Wu JQ, et al. Guided bone regeneration-assisted orthodontic treatment for clo-sing the space of missing central incisors[J]. West China J Stomatol, 2021, 39(4): 482-488.
30 周梦琪, 陈学鹏, 傅柏平. 正畸治疗中牙槽骨骨开窗骨开裂的预防和应对策略[J]. 国际口腔医学杂志, 2021, 48(5): 600-608.
Zhou MQ, Chen XP, Fu BP. Strategies for preven-ting alveolar-bone dehiscence and fenestration du-ring orthodontic treatment[J]. Int J Stomatol, 2021, 48(5): 600-608.
31 Xiao WL, Zhang DZ, Chen XJ, et al. Osteogenesis effect of guided bone regeneration combined with alveolar cleft grafting: assessment by cone beam computed tomography[J]. Int J Oral Maxillofac Surg, 2016, 45(6): 683-687.
32 Roccuzzo M, Marchese S, Dalmasso P, et al. Perio-dontal regeneration and orthodontic treatment of severely periodontally compromised teeth: 10-year results of a prospective study[J]. Int J Periodontics Restorative Dent, 2018, 38(6): 801-809.
33 Attia MS, Shoreibah EA, Ibrahim SA, et al. Rege-nerative therapy of osseous defects combined with orthodontic tooth movement[J]. J Int Acad Periodontol, 2012, 14(1): 17-25.
34 田燕, 钱若谷, 张媛, 等. 牙槽骨缺损区引导骨再生后正畸牙移动的临床观察1例[J]. 实用口腔医学杂志, 2020, 36(1): 132-133.
Tian Y, Qian RG, Zhang Y, et al. Clinical observation of a case treated by orthodontic tooth movement after guided bone regeneration in alveolar bone defect area[J]. J Pract Stomatol, 2020, 36(1): 132-133.
35 Ito K, Nanba K, Murai S. Effects of bioabsorbable and non-resorbable barrier membranes on bone augmentation in rabbit calvaria[J]. J Periodontol, 1998, 69(11): 1229-1237.
36 Machibya FM, Zhuang YY, Guo WZ, et al. Effects of bone regeneration materials and tooth movement timing on canine experimental orthodontic treatment[J]. Angle Orthod, 2018, 88(2): 171-178.
37 刘鑫, 周咏, 汪洋, 等. GBR植骨效果的远期稳定性不优于自体骨移植[J]. 口腔医学, 2019, 39(1): 63-65.
Liu X, Zhou Y, Wang Y, et al. GBR is not superior to autogenous grafting in long-term stability of grafted bone[J]. Stomatology, 2019, 39(1): 63-65.
38 Meloni SM, Jovanovic SA, Urban I, et al. Horizontal ridge augmentation using GBR with a native collagen membrane and 1∶1 ratio of particulate xenograft and autologous bone: a 3-year after final loa-ding prospective clinical study[J]. Clin Implant Dent Relat Res, 2019, 21(4): 669-677.
39 Mendoza-Azpur G, de la Fuente A, Chavez E, et al. Horizontal ridge augmentation with guided bone regeneration using particulate xenogenic bone substitutes with or without autogenous block grafts: a randomized controlled trial[J]. Clin Implant Dent Relat Res, 2019, 21(4): 521-530.
40 Amaral Valladão CA, Freitas Monteiro M, Joly JC. Guided bone regeneration in staged vertical and ho-rizontal bone augmentation using platelet-rich fibrin associated with bone grafts: a retrospective clinical study[J]. Int J Implant Dent, 2020, 6(1): 1-10.
41 Tay JRH, Lu XJ, Lai WMC, et al. Clinical and histological sequelae of surgical complications in horizontal guided bone regeneration: a systematic review and proposal for management[J]. Int J Implant Dent, 2020, 6(1): 76.
42 Lim G, Lin GH, Monje A, et al. Wound healing complications following guided bone regeneration for ridge augmentation: a systematic review and meta-analysis[J]. Int J Oral Maxillofac Implants, 2018, 33(1): 41-50.
43 Park JC, Kim CS, Choi SH, et al. Flap extension attained by vertical and periosteal-releasing incisions: a prospective cohort study[J]. Clin Oral Implants Res, 2012, 23(8): 993-998.
44 Stoppenbrink D, Daratsianos N, Kutschera E, et al. Dimensional changes of the alveolar ridge contour of the premolar extraction site in adolescents[J]. J Orofac Orthop, 2019, 80(4): 205-215.
45 Kim YK, Ku JK. Extraction socket preservation[J]. J Korean Assoc Oral Maxillofac Surg, 2020, 46(6): 435-439.
46 Lu JJ, Wang ZS, Zhang HY, et al. Bone graft mate-rials for alveolar bone defects in orthodontic tooth movement[J]. Tissue Eng Part B Rev, 2022, 28(1): 35-51.
47 Seifi M, Ghoraishian SA. Determination of ortho-dontic tooth movement and tissue reaction follo-wing demineralized freeze-dried bone allograft graf-ting intervention[J]. Dent Res J (Isfahan), 2012, 9(2): 203-208.
48 董一磊, 王科明, 陈勇, 等. 位点保存术对减数下颌双侧第一磨牙正畸牙移动的影响对照研究[J]. 现代实用医学, 2018, 30(10): 1353-1354.
Dong YL, Wang KM, Chen Y, et al. A comparative study on the effect of site preservation on orthodontic tooth movement of bilateral mandibular first molars[J]. Mod Pract Med, 2018, 30(10): 1353-1354.
49 El Shazley N, Hamdy A, El-Eneen HA, et al. Bioglass in alveolar bone regeneration in orthodontic patients: randomized controlled clinical trial[J]. JDR Clin Trans Res, 2016, 1(3): 244-255.
50 Reichert C, Wenghoefer M, Kutschera E, et al. Ridge preservation with synthetic nanocrystalline hydroxyapatite reduces the severity of gingival invaginations-a prospective clinical study[J]. J Orofac Orthop, 2014, 75(1): 7-15.
51 Zere E, Einy S, Asbi T, et al. Orthodontic extraction space closure with and without socket preservation: a comparative case analysis[J]. Quintessence Int, 2019, 50(4): 306-314.
52 Keranmu D, Nuermuhanmode N, Ainiwaer A, et al. Clinical application of concentrate growth factors combined with bone substitute in alveolar ridge preservation of anterior teeth[J]. BMC Oral Health, 2022, 22(1): 54.
53 Amaroli A, Colombo E, Zekiy A, et al. Interaction between laser light and osteoblasts: photobiomodulation as a trend in the management of socket bone preservation-a review[J]. Biology (Basel), 2020, 9(11): E409.
54 Rosero KAV, Sampaio RMF, Deboni MCZ, et al. Photobiomodulation as an adjunctive therapy for alveolar socket preservation: a preliminary study in humans[J]. Lasers Med Sci, 2020, 35(8): 1711-1720.
55 Monea A, Beresescu G, Boeriu S, et al. Bone hea-ling after low-level laser application in extraction sockets grafted with allograft material and covered with a resorbable collagen dressing: a pilot histolo-gical evaluation[J]. BMC Oral Health, 2015, 15: 134.
56 刘帅, 赵瑞, 汪俊妍, 等. 自体牙骨粉移植改善正畸治疗中牙槽骨骨量不足的临床效果[J]. 中国医科大学学报, 2019, 48(2): 105-108, 113.
Liu S, Zhao R, Wang JY, et al. Efficacy of autogenous tooth bone graft material for patients with al-veolar bone deficiency in orthodontic treatment[J]. J China Med Univ, 2019, 48(2): 105-108, 113.
57 MacBeth N, Trullenque-Eriksson A, Donos N, et al. Hard and soft tissue changes following alveolar ridge preservation: a systematic review[J]. Clin Oral Implants Res, 2017, 28(8): 982-1004.
58 Cook DC, Mealey BL. Histologic comparison of healing following tooth extraction with ridge preservation using two different xenograft protocols[J]. J Periodontol, 2013, 84(5): 585-594.
59 Ma ZG, Zheng JS, Yang C, et al. A new modified bone grafting technique for periodontally accelera-ted osteogenic orthodontics[J]. Medicine (Baltimore), 2018, 97(37): e12047.
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[3] 王昆润. 咀嚼口香糖对牙周组织微循环的影响[J]. 国际口腔医学杂志, 1999, 26(06): .
[4] 宋红. 青少年牙周炎外周血分叶核粒细胞的趋化功能[J]. 国际口腔医学杂志, 1999, 26(06): .
[5] 高卫民,李幸红. 发达国家牙医学院口腔种植学教学现状[J]. 国际口腔医学杂志, 1999, 26(06): .
[6] 侯锐. 正畸患者釉白斑损害的纵向激光荧光研究[J]. 国际口腔医学杂志, 1999, 26(05): .
[7] 轩东英. 不同赋形剂对氢氧化钙抗菌效果的影响[J]. 国际口腔医学杂志, 1999, 26(05): .
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