The influence of minimally invasive jaw surgery combined with orthodontic treatment for maxillary protrusion on tooth roots and alveolar bone

doi:10.19439/j.sjos.2025.06.005

Abstract

Abstract: PURPOSE: To explore the effects of minimally invasive jaw surgery combined with orthodontic treatment on the root length of maxillary anterior teeth and alveolar bone thickness after correcting maxillary protrusion, and to provide a reference for the selection of clinical treatment plans. METHODS: A total of 40 female patients with maxillary protrusion who visited Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from January 2018 to February 2024 were selected and divided into two groups according to the treatment plan: the experimental group(n=20) received minimally invasive jaw surgery combined with orthodontic treatment, and the control group(n=20) received orthodontic treatment with simple tooth extraction. The orthodontic treatment course and changes in the root length of maxillary anterior teeth and alveolar bone thickness before and after treatment were compared between the two groups. RESULTS: The space closure time in the experimental group was (7.2±1.15) months, and the total orthodontic treatment time was (19.6±3.35) months, both significantly shorter than those in the control group [(12.93±1.27) months and (27.0±3.22) months, respectively] (P<0.001); there was no significant difference in the alignment and leveling time between the two groups(P=0.63). Root resorption of maxillary anterior teeth occurred in both groups after treatment, but there was no significant difference between the two groups(P>0.05). The thickness of the labial alveolar bone at the root neck and mid-root regions increased in the experimental group after treatment, while it decreased in the control group, and the difference between the two groups was significant (P<0.01). CONCLUSIONS: Minimally invasive jaw surgery combined with orthodontic treatment for maxillary protrusion can significantly shorten the orthodontic treatment course and increase the thickness of the labial alveolar bone of maxillary anterior teeth to reduce the risk of bone dehiscence and fenestration. However, it cannot reduce orthodontically related root resorption.

Key words: Maxillary protrusion, Minimally invasive jaw surgery, Orthodontic treatment, Root resorption, Alveolar bone thickness

CLC Number:

Zhou Qin, Chen Qiwen, Yan Jieya, Liu Jiaqiang. The influence of minimally invasive jaw surgery combined with orthodontic treatment for maxillary protrusion on tooth roots and alveolar bone[J]. Shanghai Journal of Stomatology, 2025, 34(6): 589-594.

References

[1] 周琴, 李雅欣, 周志捷, 等. 微创颌骨手术联合正畸治疗改善上颌前突的临床研究[J]. 中华口腔正畸学杂志,2023, 30(3): 142-147.
[2] Elias KG, Sivamurthy G, Bearn DR.Extraction vs nonextraction orthodontic treatment: a systematic review and meta-analysis[J]. Angle Orthod, 2024, 94(1):83-106.
[3] Barlow M, Kula K.Factors influencing efficiency of sliding mechanics to close extraction space: a systematic review[J]. Orthod Craniofac Res, 2008, 11(2):65-73.
[4] Fisher MA, Wenger RM, Hans MG.Pretreatment characteristics associated with orthodontic treatment duration[J]. Am J Orthod Dentofacial Orthop, 2010, 137(2):178-186.
[5] Darwiche F, Khodari E, Aljehani D, et al.Comparison of effectiveness of corticotomy-assisted accelerated orthodontic treatment and conventional orthodontic treatment: a systematic review[J]. J Contemp Dent Pract, 2020, 21(6): 701-709.
[6] Aboul-Ela SM, El-Beialy AR, El-Sayed KM, et al.Miniscrew implant-supported maxillary canine retraction with and without corticotomy-facilitated orthodontics[J]. Am J Orthod Dentofacial Orthop, 2011, 139(2): 252-259.
[7] Chandra RV, Rachala MR, Madhavi K, et al.Periodontally accelerated osteogenic orthodontics combined with recombinant human bone morphogenetic protein-2: an outcome assessment[J].J Indian Soc Periodontol, 2019, 23(3):257-263.
[8] 姜若萍, 张丁, 傅民魁. 固定正畸后牙根吸收的部分影响因素分析[J]. 中华口腔医学杂志, 2003, 38(6): 58-60.
[9] 李煌, 武秀萍, 黄兰, 等. 正畸根尖区牙根外吸收的风险因素及其临床处理建议的专家共识[J]. 华西口腔医学杂志,2022, 40(6): 629-637.
[10] Weltman B, Vig KW, Fields HW, et al.Root resorption associated with orthodontic tooth movement: a systematic review[J]. Am J Orthod Dentofacial Orthop, 2010, 137(4):462-476.
[11] Sondeijker CFW, Lamberts AA, Beckmann SH, et al.Development of a clinical practice guideline for orthodontically induced external apical root resorption[J]. Eur J Orthod, 2020, 42(2): 115-124.
[12] 白玉兴. 正畸治疗中的风险认识与风险管理[J]. 中华口腔医学杂志, 2019, 54(12): 793-797.
[13] Cuoghi OA, Aiello CA, Consolaro A, et al.Resorption of roots of different dimension induced by different types of forces[J]. Braz Oral Res, 2014, 28: S1806-83242014000100231.
[14] Bellini-Pereira SA, Almeida J, Aliaga-Del Castillo A, et al. Evaluation of root resorption following orthodontic intrusion: a systematic review and meta-analysis[J]. Eur J Orthod, 2021, 43(4): 432-441.
[15] Akl HE, El-Beialy AR, El-Ghafour MA, et al.Root resorption associated with maxillary buccal segment intrusion using variable force magnitudes[J]. Angle Orthod, 2021, 91(6): 733-742.
[16] Samandara A, Papageorgiou SN, Ioannidou-Marathiotou I, et al.Evaluation of orthodontically induced external root resorption following orthodontic treatment using cone beam computed tomography (CBCT): a systematic review and meta-analysis[J]. Eur J Orthod, 2019, 41(1): 67-79.
[17] Ma ZG, Yang C, Xie QY, et al.A novel surgical technique for augmented corticotomy-assisted orthodontics: bone grafting with periosteum[J]. J Oral Maxillofac Surg, 2016, 74(1):170-180.
[18] Patterson BM, Dalci O, Papadopoulou AK, et al.Effect of piezocision on root resorption associated with orthodontic force: a microcomputed tomography study[J]. Am J Orthod Dentofacial Orthop, 2017, 151(1): 53-62.
[19] Consolaro A.Force distribution is more important than its intensity![J]. Dental Press J Orthod, 2014, 19(1): 5-7.
[20] Ahn HW, Seo DH, Kim SH, et al.Morphologic evaluation of dentoalveolar structures of mandibular anterior teeth during augmented corticotomy-assisted decompensation[J]. Am J Orthod Dentofacial Orthop, 2016, 150(4): 659-669.
[21] 王亮, 程磊, 王林, 等. 骨皮质切开术辅助上切牙内收后对牙根及牙槽骨影响的锥形束CT研究[J]. 口腔医学,2021, 41(6): 503-508.
[22] 许天民, 刘妍, 江久汇, 等. 正畸内收上切牙对上颌牙槽骨改建的临床研究[J]. 实用口腔医学杂志, 2004, 20(4): 431-433.
[23] Jäger F, Mah JK, Bumann A.Peridental bone changes after orthodontic tooth movement with fixed appliances: a cone-beam computed tomographic study[J]. Angle Orthod, 2017, 87(5): 672-680.
[24] Sarikaya S, Haydar B, Ciger S, et al.Changes in alveolar bone thickness due to retraction of anterior teeth[J]. Am J Orthod Dentofacial Orthop, 2002, 122(1): 15-26.
[25] Sun L, Yuan L, Wang B, et al.Changes of alveolar bone dehiscence and fenestration after augmented corticotomy-assisted orthodontic treatment: a CBCT evaluation[J]. Prog Orthod, 2019, 20(1): 7.
[26] Bhattacharya P, Bhattacharya H, Anjum A, et al. Assessment of corticotomy facilitated tooth movement and changes in alveolar bone thickness-a CT scan study[J]. J Clin Diagn Res, 2014, 8(10): ZC26-30.
[27] Vardimon AD, Oren E, Ben-Bassat Y.Cortical bone remodeling/tooth movement ratio during maxillary incisor retraction with tip versus torque movements[J]. Am J Orthod Dentofacial Orthop, 1998, 114(5): 520-529.