Accelerating orthodontic tooth movement with the aid of periodontal surgery - the practitioner viewpoint

Abstract

INTRODUCTION: There has been a revival of interest in the acceleration of orthodontic tooth movement (OTM) by inducing injury to dentoalveolar cortical bone. Termed corticotomy, the procedure offers an advantage to adult patients whose bone metabolism is such that any reduction in treatment time would be welcomed. The procedure has been refined for over 100 years and recent research indicates treatment duration may be reduced often by as much as a third, but it is not clear how widely the method is applied in practice. For the procedure to be successful, careful interdisciplinary management by orthodontists and periodontists is required. However, information regarding the attitude and knowledge of practitioners and the frequency of the procedure performed in Australia and New Zealand is lacking. METHODS: A questionnaire was formulated and tested in a pilot study on postgraduate orthodontic and periodontic students at The University of Adelaide. As a consequence of the responses, the wording of several questions was clarified and the sequence modified to produce the final format. Separate questionnaires were developed for specialist orthodontists and periodontists in keeping with their different backgrounds and were distributed at two relevant conferences. RESULTS AND CONCLUSIONS: The number of practitioners who had been involved with at least one corticotomy per annum was low for orthodontists (12%) and periodontists (18%). The majority of those surveyed believed that more research was required on corticotomy-facilitated OTM and would not recommend the procedure to patients without greater investigation of the technique. More than half of the sampled orthodontists indicated that they would never recommend corticotomy-facilitated orthodontics to their patients. The minority who were willing to recommend the procedure would limit involvement to adult patients, the management of ankylosed teeth, impacted canines and patients susceptible to root resorption. Over 90% of the sampled periodontists believed that there were adverse side effects.