Dentoalveolar distraction cochi ida
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Transcript of Dentoalveolar distraction cochi ida
Definition•A PROCESS OF NEW BONE FORMATION
BETWEEN THE SURFACES OF BONE SEGMENTS GRADUALLY SEPARATED BY INCREMENTAL TRACTION.
…basics, what is it ???
1992, McCarthy
1951- Ilizarov
Chin & Toth (1996): Kisnisci et al and Iseri et al (2002)
Literature Review and need of DAD
• Orthodontic tooth movement rate= 1mm a month
• Dentoalveolar Distraction movement rate= 1mm a day
Orthodontics movement Vs Distraction
Bimax protrusion
Anterior Crowding
FOT with first premolar Extraction and Canine Retraction
Minimum anchorage loss
When we do canine distraction ?
Ilizarov’s – “Siberian surgical technique” Latency phase
Initial migration of connective tissue into the osteotomy site in which occurs to re-establish the continuity of soft tissue covering.
Distraction phaseGradual incremental separation of two bone pieces at a rate of 0.8-1mm/day
Consolidation phaseNew bone is formed in the regenerate zone …osteoid tissue is laid down between the bone ends . distraction regenerates, mineralizes and achieves functional activity…. Maturation of regenerated bone.
Keyed in for success……
•stability of the distractor•observing adequate latency period•proper rate and rhythm of the
distraction process•allowing for a consolidation periods
Horizontal Alveolar Distraction Osteogenesis
The objectives of this portion of the study was to achieve rapid canine distalization by segmental horizontal alveolar distraction.
Materials and methods - 10 teeth in three patients … whose orthodontic treatment required extraction of the upper and lower first pre molar.
Results- Duration – 8 to 12 daysDistal displacement – 6 to 8 mm
Custom made semi-rigid distraction device
Canine Distractor screw with molar and canine bands
Protocol • Latency – 3-7 days
•Rate of distraction was 0.4 mm – twice daily
Distraction Phase averaged at 10-12 days.Orthodontic treatment started following the Consolidation Phase ?
Orthodontic movement can be as fast as 1.2 mm a week
Dento alveolar distraction …surgery to scale
Surgical procedureCrevicular incision and mucoperiosteal flap was elevated
Vertical Osteotomy cut made surrounding the canine
Pre molar extracted after the Osteotomy cut
Depth of the pre molar socket increased
Bony interferences eliminated
Intra oral distraction device fixation and the dento alveolar segment was mobilized.
Pat Patient - 1n -2,Nargis 28/ F
Patient - 1
Patient -2, 18/f
…18/f
Patient -3, 22/f
Advantages
Overall treatment time is reduced to 50 %
0.8 mm movement a dayAnterior segment can be
retracted simultaniously using Zygoma Implants
Over all treatment time could be reduced to 5 months.
Results
Patient Teeth Movement achieved
1 13, 23 13- 7mm , 23- 8mmLatency period – 6 days , DO @ 0.4mm– twice daily, 12 days.
Patient Teeth Movement achieved
2 13, 23, 33, 43
13- 8mm , 23- 7mm , 33- 8mm, 43- 9mm Latency period - 6 days , DO @ 0.4mm- twice daily,13 days.
Patient Teeth Movement achieved
1 13, 23 13- 7mm , 23- 8mmLatency period – 6 days , DO @ 0.4mm– twice daily.
2 13, 23, 33, 43 13- 8mm , 23- 7mm , 33- 8mm, 43- 9mm Latency period - 6 days , DO @ 0.4mm- twice daily.
3 13, 23, 33, 43 13- 7 mm, 23- 8mm, 33- 9mm, 43- 7mmLatency period – 6 days , DO @ 0.4mm twice daily.
Radiographs
Frequent appointmentsGingival recession Extrusion of teethDelayed thermal responseTooth Out of the archPain Distractor LooseningBulky Appliance
Pit Falls
Future DistractorsBioresorable distraction appliances
(inside –resorable part & out side tissue – detachable metal part )
Flexible Distracters (rigid part – inside & flexible spring like outside )
Micro incremental motor driven devices Hydraulic devices and magnetic devices
Thank You
