Tooth orthodontic movement after maxillofacial surgery

SUMMARYThe purpose of this study was to compare the rate of orthodontic tooth movement into regenerated bone, created after mandibular Distraction Osteogenesis (DO), with the rate of orthodontic tooth movement in patients who had extractions. The Sample Group (treated subjects) was composed of 14 Class II patients (5 males and 9 females, mean age 25.0±1.1years) treated with a Distraction Osteogenesis appliance. to obtain orthodontic tooth movement in regenerated bone. The Control Group (extraction cases) was composed of 14 subjects (mean age 21.9±3.1 years). This Group was treated with extractions. Both groups were followed by conventional orthodontic treatment for space closure. Teeth movements (amount and rate) were evaluated by measuring the distance between the distal wing of the canine bracket and the mesial wing of the first or the second premolar bracket, depending on the group, using Vernier callipers (Dentaurum). Readings were noted every 2 weeks until space closure was completed. In this study the mean duration of the post-distraction orthodontic treatment was 12±0.3 months. Our study showed that the space created by distraction was closed in 10±1 months; while with conventional orthodontic treatment the average time to complete space closure was 5.90±.9 months. The average space closure was 6.50±0.10mm with conventional orthodontic treatment and 7.90 ±0.38 mm in the patients treated with DO. The mean rate of tooth movement was 1.27±0.23 mm/month in the group with conventional orthodontic treatment and 0.68±0.20mm/month in the group treated with DO. Unpaired t test showed a significant difference between tooth movement in the study sample and in the control group (p<.05). As suggested by most scientific literature, in our sample dental movement was started at the end of the consolidation phase. However, the rate of space closure in the distraction area was higher than with conventional orthodontic treatment. Undoubtedly, this approach can be used for the treatment of very severe skeletal malocclusions and maxillofacial deformities, but it cannot be considered an alternative to conventional orthodontic surgery to accelerate treatment because tooth movement in edentulous spaces created by osteodistraction requires more time.