Osseous resective surgery involves recontouring bone through ostectomy or osteoplasty to establish a healthier periodontal pocket depth. The goal is to create a shallower pocket that is easier to maintain. Indications for osseous resection include shallow infrabony defects, one-walled angular defects, and furcation involvement. Contraindications are deep isolated defects and advanced periodontitis. The surgery involves raising a mucoperiosteal flap and reshaping the bone using burs and chisels, then suturing the flap.
It restore alveolar bone to the level existing at the time of surgery or slightly more apical to this level. Aim is to achieve positive bony architecture.
STEPS INCLUDE:
1.VERTICAL GROOVING
2. RADICULAR BLENDING
3. FLATTENING INTERPROXIMAL BONE
4. GRADUALIZING MARGINAL BONE
PREFERRED TREATMENT FOR ONE WALLED PERIODONTAL BONE DEFECTS (HEMISEPTUM)
ROS is a substractive method of having positive bone architecture. it includes osteotomy and ostectomy procedures. osteotomy is to remove non supporting bone and ostectomy is to remove supporting bone for having positive bony architecture. there is definitive osseous surgery and compromise osseous surgery. transgingival probing is a method of determining osseous topography. various hand and rotary instruments are use for this procedure.
It restore alveolar bone to the level existing at the time of surgery or slightly more apical to this level. Aim is to achieve positive bony architecture.
STEPS INCLUDE:
1.VERTICAL GROOVING
2. RADICULAR BLENDING
3. FLATTENING INTERPROXIMAL BONE
4. GRADUALIZING MARGINAL BONE
PREFERRED TREATMENT FOR ONE WALLED PERIODONTAL BONE DEFECTS (HEMISEPTUM)
ROS is a substractive method of having positive bone architecture. it includes osteotomy and ostectomy procedures. osteotomy is to remove non supporting bone and ostectomy is to remove supporting bone for having positive bony architecture. there is definitive osseous surgery and compromise osseous surgery. transgingival probing is a method of determining osseous topography. various hand and rotary instruments are use for this procedure.
Vertical ridge augmentation is sometimes required for dental implant placement. The presentation looks at various conventional and newer techniques for ridge augmentation in the oral cavity.
Biologic width - Importance in Periodontal and Restorative DentistryDr.Shraddha Kode
Biologic width plays a vital role for preservation of the periodontal health. This concept involves the dimensions of the epithelial and connective tissue attachment between the base of the sulcus and the alveolar crest which if involved can lead to gingival inflammation and gingival recession.
Advanced soft tissue & hard tissue grafting Clinical TrainingDr. Rajat Sachdeva
Growth Factors, Tenting screws, Sinuslifts, Endoscopic evaluation of sinuslifts, Block grafts, Particulate grafts, Exomed application, Bone ring, CT/FGG grafts harvest/application, Peri-implantitis management, Suturing. Armamentarium, Choice of Biomaterial.
Course Insight :-
Ø Harvesting of autogenous bone from different intraoral sites
Ø Selection of the appropriate graft substitute
Ø Performing minimal invasive grafting procedures
Ø Successfully performing all the intraoral bone grafting procedures in implant practice such as
a) Using Particulate bone substitutes to graft the periimplant bone defects
b) Socket grafting
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Indian Dental Academy: will be one of the most relevant and exciting
training center with best faculty and flexible training programs
for dental professionals who wish to advance in their dental
practice,Offers certified courses in Dental
implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic
Dentistry, Periodontics and General Dentistry.
The content covers majority of the aspect of immediate implant placement - why immediate implants?, case selection, decision making, classifications, surgical technique, healing following immediate implant placement, immediate implants in infected sockets/periapical infections, literature reviews and recommendations for clinical practice.
Vertical ridge augmentation is sometimes required for dental implant placement. The presentation looks at various conventional and newer techniques for ridge augmentation in the oral cavity.
Biologic width - Importance in Periodontal and Restorative DentistryDr.Shraddha Kode
Biologic width plays a vital role for preservation of the periodontal health. This concept involves the dimensions of the epithelial and connective tissue attachment between the base of the sulcus and the alveolar crest which if involved can lead to gingival inflammation and gingival recession.
Advanced soft tissue & hard tissue grafting Clinical TrainingDr. Rajat Sachdeva
Growth Factors, Tenting screws, Sinuslifts, Endoscopic evaluation of sinuslifts, Block grafts, Particulate grafts, Exomed application, Bone ring, CT/FGG grafts harvest/application, Peri-implantitis management, Suturing. Armamentarium, Choice of Biomaterial.
Course Insight :-
Ø Harvesting of autogenous bone from different intraoral sites
Ø Selection of the appropriate graft substitute
Ø Performing minimal invasive grafting procedures
Ø Successfully performing all the intraoral bone grafting procedures in implant practice such as
a) Using Particulate bone substitutes to graft the periimplant bone defects
b) Socket grafting
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Indian Dental Academy: will be one of the most relevant and exciting
training center with best faculty and flexible training programs
for dental professionals who wish to advance in their dental
practice,Offers certified courses in Dental
implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic
Dentistry, Periodontics and General Dentistry.
The content covers majority of the aspect of immediate implant placement - why immediate implants?, case selection, decision making, classifications, surgical technique, healing following immediate implant placement, immediate implants in infected sockets/periapical infections, literature reviews and recommendations for clinical practice.
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The main concept of osseodensification technique is that the drill designing creates an environment which enhances the initial primary stability through densification of the osteotomy site walls by means of autografting of bone.
Corticotomy facilitated orthodontics
Although the art and science of orthodontics have progressed significantly over the past 100 years, relatively little has been done to enhance the rate at which tooth movement occur. Many methods have been done to enhance the rate of tooth movement. These methods include the injection of biologically active peptides, the use of magnets and even the application of electric current and corticotomy.
Corticotomy: is slight penetration through the cortical bone and did not be confused with the osteotomy. Or defined as incision made into the cortical bone.
This penetration or incision leads to decrease the resistance of the alveolar and diminish physical alveolar bone contact that accelerates the rate of tooth movement.
Several authors have described rapid tooth in conjunction with corticotomy surgery as movement by bony (Block). Kole6 was the first describe the corticotomy as a surgical procedure in which one tooth or group of teeth with the adjacent bone is repositioned in one step. But others prefer to call this osteo-corticotomy or intra alveolar segmental osteotomy, reserving the term corticotomy for a technique in which cuts are made in the buccal cortical plate of bone. So that the segment to be moved orthodontically is held only by cancellous trabeculea and palatal cortical bone.
Kole in 19596 reported combining orthodontics with corticotomy surgery and complete the active tooth movement in adult orthodontic cases in 6 to 12 weeks.
The inter-proximal corticotomy cuts were extended through the entire thickness of the cortical layer, just barely penetrating the medullary bone.
The vertical cuts were connected beyond the apices of the teeth with horizontal osteotomy cut extending through the entire thickness of the alveolus, essentially creating blocks of bone in which one or more teeth were embedded, using the crowns of the teeth as a handles. Kole believed that he was able to move the blocks of bone some what independly of each other because they were only connected by less-dense medullary bone. He found no incidence of root resorption, no loss of tooth vitality and no pocket formation.
Kole used this surgical technique for correction of some of dento-alveolar problems as:
Protruding of lower incisors: this procedure is indicated in most of cases but should be determined whether a mandibular or dento-alveolar retrusion. Buccally the cortiocotomy is performed between the incisors and canine then horizontal cut is made 1cm. below the incisors, lingual two vertical and one horizontal cut is made fig(1).
Distal displacement of a single tooth or group of teeth: correction necessitates a long period of treatment in adult patients fig(2) .
The retrusion of all six lower anterior teeth: after buccal and ligual corticotomy is perefrmed.
Alignment of rotated teeth.
Correction of spaced teeth: in maxillary and mandibular protrusion with diastemas between the t
Periodontally Accelerated Osteogenic Orthodontics with Piezoelectric Surgery...Abu-Hussein Muhamad
Piezosurgery has been applied in dentistry for many years. This paper reviews specifically the treatment applications that have been used in surgically assisted orthodontic treatment since the last decade. Periodontally Accelerated Osteogenic Orthodontics (PAOO) is a surgical technique which results in an increase in alveolar bone width, shorter treatment time, increase post-treatment stability, and decrease amount of apical root resorption. The aim of this case report is to compare the use of micro-motor and piezoelectric surgery unit during decortication in Periodontally Accelerated Osteogenic Orthodontics technique.
Key words: Piezoelectric surgery, piezosurgery, Periodontal regeneration , accelerated tooth movement
Abstract: Corticotomy-assisted orthodontic treatment is an established and efficient orthodontic technique that has recently been studied in a number of publications. Corticotomy facilitated orthodontics have been employed in various forms over speed up orthodontic treatment It involves selective alveolar decortication in the form of decortication lines and dots performed around the teeth that are to be moved. It is done to induce a state of increased tissue turnover and a transient osteopenia, which is followed by a faster rate of orthodontic tooth movement. This technique has several advantages, including faster tooth movement, shorter treatment time, safer expansion of constricted arches, enhanced post-orthodontic treatment stability and extended envelope of tooth movement. The aim of this article is to present a comprehensive review of the literature, including historical background, contemporary clinical techniques, indications, contraindications, complications and side effects. Keywords: Corticotomy, decortication, review, orthodontic treatment
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Orthodontic extrusion in dentistry, an overall look.
This brief presentation will explain the main points regarding: 1- Indications &
Contraindications
2- Extrusion Types,
3- Biological Response,
4-Optimum Force,
5-ExtrusionProtocols,
6- Case,
7-Knowledge Gap.
This presentation is well cited based on previous published researches, and different books like Profitt contemporary orthodontics.
It was supervised and presented to a group of orthodontics who are highly respected in their field.In addition to dental interns, orthodontic attachments and seniors of the Saudi Board of Orthodontics.
1. Osseous Resective Surgeries: Ostectomy and Osteoplasty
Chapter 13:
Osseous resective surgery is one method of treatment that may be implemented to repair
an osseous defect. The goal of this surgery is to reestablish a healthy periodontal pocket depth
through recontouring of the bone. An ideal periodontal pocket after this surgery is one that has a
shallower depth, allowing the patient and clinician to maintain the pocket depth more effectively.
The surgeon must take into account, however, the extent of the defect. (Vernino, Gray &
Hughes, 2008) According to Vernino, Gray, and Hughes, “the indications for definitive osseous
resective surgery are limited to incipient or moderate osseous defects...”. A conservative
approach must be taken in order to leave enough bone to support the teeth. There are two
categories of osseous resective surgery: ostectomy and osteoplasty. Osteoplasty is the removal
of non-tooth supporting bone. Ostectomy is the removal of bone that supports the tooth (it
contains periodontal ligament fibers). (Perry & Beemsterboer, 2007)
There are two types of pocket destruction. A suprabony pocket is one that the base of the
pocket is coronal to the alveolar crest. This is seen in horizontal bone destruction. An infrabony
pocket is one that is apical to the alveolar crest– it results in vertical or angular destruction of the
bone. Infrabony (angular) pockets are categorized by the number of bone supporting walls
present: one-walled (hemiseptal), two-walled, and three-walled (intrabony). (Reddy, 2008) A
three-walled (intrabony) defect has the most bone support and the one-walled has the least.
Indications for osseous resection include: shallow infrabony defects (1-2mm), one-walled
angular defects, furcation involvement, thick bony margins, flat or reverse architecture, tori,
exostoses and ledges, and use in conjunction with root resection surgery. (Reddy, 2008)
(Vernino, Gray, & Hughes, 2008)
Contraindications of osseous resection include: isolated deep defects where too much
tooth-supporting bone will be lost, such as a three-walled osseous defect, advanced periodontitis,
patients at a high risk for caries or those with extreme root sensitivity (osseous resection exposes
the root surface), patients with improper oral hygiene, systemic conditions, and unacceptable
esthetic results (i.e. anterior region). ( Reddy, 2008) (Vernino, Gray & Hughes, 2008)
The mucoperiosteal tissue is flapped using a para-marginal or sub-marginal incision.
Additional releasing incisions may be used to add visibility. Interdental defects or crests may be
completely flattened or recontoured using a palatal/lingual approach. The bone is reshaped using
a round bur and finished with bone files. Residual bone left at the line angles of the teeth, called
widow’s peaks, are removed with hand chisels. Next the flap is repositioned and sutured using a
vertical or horizontal periosteal mattress suture. An interrupted or continuous technique may be
used. A periodontal dressing may or may not be placed. (Dibart & Dietrich, 2010)
2. (Reddy, 2008) A one-wall defect; this wall has (Reddy, 2008) A two-walled defect
the least amount of tooth-supporting
bone remaining
(Reddy, 2008) A three-walled defect has (Narayanaswamy, 2007)
the most bone support remaining
(Kenney, 1998)
Osteoplasty: Removal of non-supportive bone; one example seen above is removal of exostoses
(Levine &
Filippelli, 1999) Osteoplasty in conjunction with ostectomy– removal of tooth-supporting bone.
Note that the recontouring of the bone follows the outline of the CEJ, creating a scalloped shape.
3. Dibart, S., & Dietrich, T. (2010). Periodontal osseous resective surgery. Practical periodontal
diagnosis and treatment planning (pp. 77-87). Iowa: Blackwell Publishing. Retrieved from
http://books.google.com.gt/books?id=h6akidbw7h8C&printsec=frontcover#v=onepage&q&f=fal
se
Kenney, B. E. (1998). UCLA periodontics information center: Flap surgery. Retrieved from
http://www.dent.ucla.edu/pic/index-3.html
Levine, D. F., & Filippelli, G. (1999). A review of osseous resective surgery. Retrieved from
Journal of the California Dental Association website:
http://www.cda.org/library/cda_member/pubs/journal/jour299/osseous.html
Narayanaswamy, K. K. (2007). Review of clinical periodontology (pp. 68). New Dehli: Jaypee
Brothers Medical Publishers. Retrieved from
http://books.google.com/books?id=EAx7TrNa45cC&printsec=frontcover&dq=review+of+clinic
al+periodontology&hl=en&ei=BtW6TuLPAeLv0gHGpeTeCQ&sa=X&oi=book_result&ct=resu
lt&resnum=1&ved=0CDYQ6AEwAA#v=onepage&q&f=false
Perry, D. A., & Beemsterboer, P. L. (2007). Chapter 13: Periodontal surgery. Periodontology for
the dental hygienist (p. 301). Missouri: Saunders.
Reddy, S. (2008). Osseous surgery. Essentials of clinical periodontology and periodontics
(pp.330-333). Missouri: Jaypee Brothers Medical Publishers. Retrieved from
http://books.google.com/books?id=WM67jyzXrAUC&printsec=frontcover#v=onepage&q&f=fal
se
Reddy, S. (2008). Bone loss and patterns of bone destruction. Essentials of clinical
periodontology and periodontics (pp. 200, 205-206). Missouri: Jaypee Brothers Medical
Publishers. Retrieved from
http://books.google.com/books?id=WM67jyzXrAUC&printsec=frontcover#v=onepage&q&f=fal
se
Vernino, A. R., Gray, J., & Hughes, E. (2008). The periodontic syllabus (pp. 189-193).
Maryland: Lippincott, Williams & Wilkins. Retrieved from
http://books.google.com/books?id=WDGZTitJoqYC&printsec=frontcover