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A novel surgical technique for augmented corticotomy-assisted orthodontics: dumpling grafting with periosteum
MA Zhi-gui, YANG Chi, XIE Qian-yang, YE Zhou-xi, PAN Lu-lu, SHEN Pei, CHEN Zhuo-zhi.
China Journal of Oral and Maxillofacial Surgery
2015, 13 (6):
515-520.
PURPOSE : To introduce the dumpling grafting with periosteum (dumpling technique) as an alternative surgical approach for augmented corticotomy-assisted orthodontics in the lower anterior region and evaluate the preliminary outcomes. METHODS : From March to August in 2014, eight patients (2 men, 6 women) with dehiscence/fenestration in the lower anterior region underwent an innovated augmented corticotomy using the dumpling technique. In this new technique, an initial split-thickness dissection was performed and then the periosteal layer was carefully elevated from the alveolar bone，facilitating subperiosteal placement of bone graft material. Then the periosteum was fixed by sutures to the alveolar bone surface in a dumpling-like fashion so as to protect the grafting materials from displacement and leakage. Cone-beam computerized tomography (CBCT) was used to evaluate morphologic changes of the lower anterior ridge before treatment (T0), and 1 week after bone-augmentation procedure (T1). Quantitative measurements of the vertical alveolar bone changes and horizontal bone thickness at the middle levels of the coronal, middle and apical thirds of the lower anterior teeth were evaluated at T0 and T1. Paired t test was performed using SPSS 16.0 software package for data analysis. RESULTS : No serious complications occurred after surgery. Augmented bone morphology was well maintained after surgery on CBCT. Alveolar bone thickness from T0 to T1 increased by (0.65±0.89) mm at the coronal third, (3.30±1.09) mm at the middle third, and (3.96±1.35) mm at the apical third on labial side. Significant horizontal bone augmentation was found in the lower anterior teeth (P < 0.01). Furthermore, vertical alveolar bone increased by (5.35 mm±1.90 mm), which also showed significant change (P<0.01). CONCLUSIONS : Augmented corticotomy-assisted surgical orthodontics using the dumpling technique could prevent bone graft material from shifting, well maintain primary augmented bone morphology, and facilitate bone regeneration at the desired position. However, long-term follow-up is necessary. Supported by Research Fund for Young College and University Teachers of Shanghai Municipal Education Commission (jdy11027), Research Fund of Shanghai Municipal Health Bureau (20134Y061) and Scientific Research Fund of Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine (2012-12).
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