A fully updated new edition of this state-of-the art reference for improving orthodontic outcomes
Orthodontically Driven Osteogenesis, Second Edition, offers a cutting-edge and comprehensive overview of regenerative corticotomy surgical techniques and their applications to dental practice. Covering all aspects of incorporating these techniques, the book includes information on selecting treatment options, improving orthodontic efficiency, and minimizing surgical exposure, with detailed step-by-step surgical techniques. The Second Edition has been rewritten with a new focus on 3D treatment planning and clear aligners, adding chapters completely dedicated to digitalization, minimally invasive tunnel technique, and orthognathic surgery, in addition to updates and new advances throughout.
Chapters are written by leading experts in the field, offering an authoritative, comprehensive resource with hundreds of high-quality images. A companion website provides video clips, the figures from the book in Power Point, and tables. Readers of the Second Edition of Orthodontically Driven Osteogenesis will also find:
- A new emphasis on digitalization, 3D planning, and clear aligner therapy
- Discussions of the process of selecting treatment options, improving orthodontic efficiency, and minimizing surgical exposure with a very strong emphasis on the osteogenic abilities of the technique
- Brand-new chapters on tunnel regenerative corticotomy and orthognathic surgery, as well as a new treatment of digitalization, 3D planning, and clear aligners
- A companion website with video clips, downloadable figures, and more
Orthodontically Driven Osteogenesis is ideal for orthodontists, periodontists, oral surgeons, and other general dentists with an interest in this topic.
Table of Content
List of Contributors xiii
Introduction xiv
1 Orthodontic Tissue Engineering: A 20-Year Retrospective and Philosophical Polemic 1
Neal C. Murphy
Dedication 1
Introductory Rationale 1
Topical Issues 4
The Alveolus Bone Is Not a Process 7
Epigenetics and the Waddington Landscape 8
From Osteotomy to Corticotomy to Tissue Engineering 10
Farrar Revisited: Bending Bone and CPO 11
Histophysiology of Orthodontically Driven Osteogenesis 14
Cell-Level Orthodontics 15
Timid Surgery and Its Consequences 15
Conceptual Foundation Through Historical Evolution 16
German Roots 16
The Introduction Into English 17
Suya and the Asian Connection 18
1980s: Anholm and the Loma Linda Investigation 18
A 20th Century Summary 20
21st Century Pioneers 21
The Entry of Academics 21
‘Wilckodontics, ‘ PAOO/AOO, and Tissue Engineering 21
The Small Window Myth 24
The ‘Need’ for Extraction Myth 24
On Beauty 25
From PAOO to SCAT; Dead Cells to Living Tissue 29
Beyond the Ligament with Mechano-biology 31
The Mechanosome 33
Enter the Exosome 35
TMP and MOP Nonsurgical Alternatives 35
The Problems with Orthodontics 38
Papillary Slough as a Troubling Complication 38
Managing Periodontal Infection 39
PAOO and SCAT Step-by-Step 40
Ortho-Infection 44
Oral Hygiene – A Pragmatic Imperative 46
Compliance Dialogue 47
Enhanced Bass Technique 47
Effective Oral Health Techniques 49
A Heretical Dehiscence Theory 49
How Fast is ‘Fast’? – A 4-Day
Treatment 51
Conclusions 52
Afterword for Academic Leaders 54
Acknowledgments 55
References 55
Recommended Reading 59
2 From Acceleration to Osteogenesis 60
Federico Brugnami
Accelerated Tooth Movement 60
Corticotomy 61
Accelerated Tooth Movement in Laboratory Animals 61
Accelerated Tooth Movement in the Canine Laboratory Model 62
Canine Study Description and Design 62
Canine Tooth Movement Data 68
Tooth Movement Paradigms: PDL Cell-Mediated versus Spongiosa Osteopenia 71
From Corticotomy to Grafting with Decortication (From Acceleration to Osteogenesis) 72
Histologic and Long-Term CBCT Evaluation 74
Conclusions 81
Acknowledgments 82
References 82
3 From Corticotomy to Orthodontically Driven Osteogenesis: Surgical Considerations 87
Alfonso Caiazzo and Federico Brugnami
Introduction 87
Historical Background 88
Biophysiologic Considerations 89
Indications for SAD or Corticotomy Alone 89
Contraindications 90
Advantages 90
Surgical Technique 90
Preoperative Considerations 90
Incision Design 91
Flap Reflection and Exposure 91
Corticotomy/Surgical Decortication 92
Bone Grafting 92
Suturing 94
Postsurgical Considerations 94
Single Flap Regenerative Corticotomy (SFRC) 95
Case 1 (SFRC) 96
Tunnel Regenerative Corticotomy (TURC) 96
Case 2 100
Conclusions 103
Acknowledgments 108
References 110
4 Orthodontically Driven Osteogenesis (ODO) Indications and Applications in Orthodontics 111
Simonetta Meuli, Federico Brugnami, and Gianfranco Giordano
Introduction 111
The Basic Concepts 113
Orthodontic Implications of Bone Injury: The RAP 114
From Corticotomy to Grafting with Decortication 115
Practical Applications and Indications 117
Maximizing the Window of Opportunity 120
Contraindications 120
Applications 121
Segmental Alveolar Decortication 121
Decortication Procedures with Clear Aligners 121
Interprofessional Communication 121
Conclusion 122
Cases Presentation 122
Introductory Note 122
Case 1 123
Case 2 124
3D Digital Planning and Clear Aligner Treatment 124
Case 3 124
Case 4 136
Conclusion 151
Acknowledgments 151
References 163
5 Three-dimensional
Digital Planning of Orthodontic Treatment: A Powerful Tool in Understanding, Communicating, and Planning Orthodontically Driven Osteogenesis 167
Simonetta Meuli
Introduction 167
Virtual Orthodontic Treatment 167
Potential of Virtual Three-dimensional 169
Traditional Versus Printing Technology 169
Imaging 171
Digital Models 171
Virtual Three-dimensional Orthodontic Planning Models 172
Integration of CBCT Into the Digital Orthodontic Treatment Flow 174
‘Clin Check’ and CBCT Integration as a Planning Tool for ODO 176
References 176
6 From Orthodontically Driven Corticotomy to Orthodontically Driven Osteogenesis: Tissue Engineering to Enhance Orthodontic Treatment, Guided by the Orthodontist 178
Federico Brugnami and Alfonso Caiazzo
Introduction 178
Surgical Techniques: The Beginning of Tissue Engineering in Orthodontics 178
Surgical Strategies: Single Flap Corticotomy (SFC) and Tunnel Regenerative Corticotomy (TURC) 179
The Concept of Orthodontically Driven Corticotomy (ODC): From ODC to ODO 185
Surgical Strategies in ODO: Segmental, Sequential, Segmental, and Sequential Approaches 185
Segmental Approach 185
Sequential Approach 190
What is ODC? 190
Case Presentation 191
Case 1 191
Case 2 194
Case 4 197
Conclusions 203
References 206
7 Orthodontic Treatment and Periodontal Side Effects: Orthodontically Driven Osteogenesis to Stretch the Limits of a Safe Orthodontic Treatment 208
Federico Brugnami and Alfonso Caiazzo
Introduction 208
Radiographic Evaluation of Orthodontic Side Effects 210
Research Experience 214
Material and Methods 216
Results 218
Conclusions 218
Dehiscences and Fenestrations 220
Indications of Use for ODO 225
Case Presentation 225
Conclusions and Recommendations 230
Acknowledgments 234
References 234
8 Orthodontically Driven Osteogenesis: Tissue Engineering to Enhance Adult and Multidisciplinary Treatment 237
Federico Brugnami and Alfonso Caiazzo
ODO in Multidisciplinary Treatment 237
Orthodontics for Prosthetic 238
Periodontics and Orthodontics Synergy: The Two Dental Specialties that Need a Healthy Periodontium 238
Case Presentation 238
Case 1 Mutilated Dentition #1: Orthodontics and Prosthodontics Connection, Enhancing the Periodontal Outcome 238
Technical Procedure 240
Case 2 The Summer Break Case: An Alternative to Veneers to Correct Esthetics in the Anterior Area 243
Case Management 243
Clinical Outcomes 244
Case 3 Mutilated dentition #2: Adjunctive Corticotomy-enhanced Segmental Orthodontics to Intrude Over-erupted
Molars and Allow Teeth Replacement in the Opposite Arch 244
One-shot Surgical Procedure Combining Corticotomy with Anchorage Plate Positioning, Wisdom Extraction, and Periodontal Surgeries 244
Case 4 Mutilated Dentition #2. Adjunctive Corticotomy-facilitated Segmental Orthodontics to Enhance Periodontics and Prosthodontics 246
Case 5 Mutilated Dentition #3: Segmental Corticotomy to Treat Unilateral Crossbite with Crowding, Rotations, and Missing Dentition 249
Case 6 Corticotomy in Periodontal Patients: Enhancing Orthodontic Treatment to Facilitate Periodontal Maintenance 249
Case 7 Malocclusion and Mutilated Detention in a Periodontally Compromised Patient: The Perfect Storm 261
Conclusions 268
References 276
9 Clear Aligners and Orthodontically Driven Osteogenesis: Boosting Treatment in the Gray Areas Between the Straightforward and the Orthognathic Cases 277
Simonetta Meuli and Federico Brugnami
Introduction 277
Birth and Development of the Invisalign Technique 277
Treatment Phases and Characteristics Peculiar to the Invisalign System 278
Advantages of the Invisalign System 279
Regenerative Corticotomy and Bone Engineering in Orthodontics with a Digital Approach 280
Orthodontics and Its ‘Limitations’ 280
Orthodontically Driven Osteogenesis in Orthodontic Treatment Planning 281
Presentation of Clinical Cases 282
Case 1 282
Case 2 283
Conclusions 287
Modifying the Lower Third of the Face 289
References 293
10 Orthognathic Surgery and Orthodontically Driven Osteogenesis 295
Simonetta Meuli, Federico Brugnami, Sergio Marrocco, Giulia Amodeo, and Domenico Scopelliti
Introduction 295
Diagnosis and Treatment Planning 296
Case 1 297
Therapy Protocol 299
Discussion 302
Case 2 303
Conclusions 307
References 309
11 Understanding the Etiological Relationship Between Orthodontic Tooth Crowding and Mucogingival Pathologies, ‘Big Teeth in Small Jaws’ 312
Colin Richman
Introduction 312
Fundamental Etiological Factors Associated with Orthodontic Tooth Crowding 312
Anthropological Factors 312
Genetic Factors 312
Dietary Factors 314
Comparative Anatomical Observations Relative to Other Mammalian Species Nurtured and Living in Their Natural Habitats 314
Vasculature of the Gingival Tissues 314
The Clinical Significance of Dehiscences and Fenestrations 316
Tooth Eruption Patterns 318
Consequences and Management Strategies, Including Phenotype Modification 319
References 323
Index 325
About the author
The editors
Federico Brugnami, DDS, Specialty in Periodontics, received his DDS from the University La Sapienza of Rome, Italy, and his certificate at Tufts University School of Dental Medicine, Boston, MA, USA. He maintains a private practice limited to periodontics, oral implants, and adult orthodontics in Rome, Italy.
Alfonso Caiazzo, DDS, is a visiting assistant professor of Oral and Maxillofacial Surgery in the Henry M. Goldman School of Dental Medicine at Boston University in Boston, Massachusetts, USA. He also maintains a private practice limited to oral surgery and implant dentistry in Salerno, Italy.
Simonetta Meuli, DDS, Ph D, DDS, Specialization in Orthodontics, is a Visiting Professor at the School of Specialization of Orthodontics, Catholic University of the Sacred Heart in Rome, Italy, and is a Visiting Professor at the School of Specialization of Orthodontics, Unicamillus International University in Rome, Italy.
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