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1. JOURNAL CLUB
INDIAN DENTAL ACADEMY
Leader in continuing dental education
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2. “ LOWER INCISOR RETRACTION
WITH A MODIFIED
CORTICOTOMY “
AO 2006,76(6);880-88
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3. INTRODUCTION


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
SURGERY – combined for better ortho
Tx
CORTICOTOMY
RAP
AOO
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4. CORTICOTOMY

“ Surgical removal of alveo bone “
OR
Osteotomy of the cortical bon

It distract the bone – growth of new bone

Moving group of teeth with alveo processspongiosa intact
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5. Review of literature




1950 Periodontists - rate of OTM
1959 Kole – 1st labial & palatal
corticotomy
1990 Dr.Wilcko: AOO - (CT scan)
mineralisation of alveolar bone –
responsible for OTM
2001 chung et al- ant retraction in
bimax
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6. CORTICOTOMY IN
ORTHODONTICS
Alternative to ortho Tx
 FASTER, less side effects & pt
compliance
 Moving blocks of bone
 ORTHO Tx TIME – resistance of the
dense cortical bone to OTM is removed

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7. INDICATIONS / USES :

Non-growing / Old / faster ortho Tx
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8. 
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
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Retraction- Class II div 1, bimax
Spacing, rotation
Intrusion (AOB)
Ankylossis
Teeth with narrow cortical bone
TSALD
T/S constricted maxillae
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9. Advantages
rate of OTM – Tx time
 Avoid adverse effects of ortho Tx :
 No gingival/PDL damage
 Root resorption
 Loss of vitality of teeth/bone
 Conservative surgery
 No retention problems & tongue
functions – after Tx

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10. Conventional :
 Both B-L cuts

2 stage surgery
Modified :
 LABIAL- only no
lingual V & sub apical
H/Z cuts
 Conservative – 1stge
Less time & pt
discomfort
 Corticotomy sitemobilised
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14. AIM
“ Rapid & effective modified alveolar
corticotomy-facilitated ortho Tx of an
adult case with severe malocclusion A CASE REPORT “
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17. Tx objectives:
Tx plan :
 X of al 4s-maxi anchorage
 Segmental canine retraction-at end
accelaration by – corticotomyfacilitated incisor retraction
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18. 

Pre op –
OPG,OCCLUSAL
Retraction-0.016 x
0.022 S.S with T
loop-1wk b4
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19. SURGERY :
 0.5mm S.S bur,
1.5-2mm depth,
2-3mm below
apices
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20. 



Immediate consolidation
3 wks- Dec OJ, Xn space closed
LI retraction - 1.5 mos
No problems of vascularity/vitality/root
resoption/gingival
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21. Results


Correction of pt
problem list
Tx completion – 16
mos
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23. Conclusion

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Effective alternative Tx – adults,sevre
malocclusion, the Tx time (50%)
Beneficial- in difficult surgical lingual
accessibility
Modified CORTI- coservative, less
time & pt discomfort, cost effective
Risk of tissue damageteeth,bone,PDL
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24. Thank you
For more details please visit
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m
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