加快正畸牙齿移动的方法

加快正畸牙齿移动的方法

南京大学医学院附属口腔医院正畸科王天丛研究的三个方向：药物刺激机械生理性刺激手术加速

药物刺激

激素类药物：前列腺素（PG）、甲状旁腺素（PTH）、肾上腺皮质激素等钙调节剂：骨钙素（OC）等中药类：丹参、灯盏花等机械生理性刺激激光磁场超声波：选择了13例对称拔牙正畸病例，实验侧局部给予超声波，10min／d×14d。结果实验侧尖牙移动速度比对照侧提高28.67%。振动手术加速骨皮质切开术corticotomy牙周辅助加速成骨治疗periodontallyacceleratedosteogenicorthodontics,PAOO牵张成骨DentoalveolarDistraction(DAD)手术优先矫治surgeryfirstorthognathicapproach正畸力作用于牙齿，引起牙槽骨的改建，压力侧出现骨吸收，张力侧出现骨沉积，从而产生牙齿移动。理论上，凡能促进骨组织改建的外源性因素均可加速正畸牙齿移动。Anoveldeviceinorthodontics

------AcceleDent®WhatisAcceleDent®Aura?

Asimple-to-use,hands-freedevicedesignedforfasterorthodontictreatmentwithonly20minutesdailyuse.It’sFast

Clinicallyproventomoveteethupto50%fasterinaUSclinicaltrial.AcceleDentisdesignedtoworkwithallexistingorthodonticappliancesincludingfixedappliancesandclearaligners.It’sSafe

ClearedbytheUnitedStatesFoodandDrugAdministration(FDA)andavailableonlybyprescriptionfromyourorthodontistIt’sGentle

AcceleDentpatientshavereportedreduceddiscomfortwiththeirorthodontics.AcceleDent®AuraComponents:

ActivatorTheheartofAcceleDentAurathesmall,lightweightActivatorgeneratesgentlemicropulsestosafelyaccelerateboneremodeling.ItincludesaUSBinterface,whchcanbepluggeddirectlyintoacomputertoviewpatientusagehistoryviatheFastTracReport.AcceleDent®AuraComponents:MouthpieceTheMouthpieceprovidesacomfortablefitsnapseasilyonandofftheActivatorfortransportandcleaning.AcceleDent®AuraComponents:USBextensioncablewithpoweradapter

Allowsforeasy,convenientchargingAcceleDent®AuraComponents:TravelCase

TheTravelCasekeepsthecomponentssafe,cleanandsecure.HowAcceleDentAuraWorks?SoftPulseTechnology™

Partofthewaythatorthodonticsworksisbychangingorremodelingthebonessurroundingyourteeth.Asthisremodelingprocessisaccelerated,yourteethmovemorequickly.

SoftPulseTechnology™isdesignedtospeedupboneremodeling,acceleratingtoothmovement

Thedeviceusestheapplicationofcyclicforcestomoveteethinbonefasterthroughacceleratedboneremodeling.Theappliedforce(0.2Newtonsor20grams)isintendedtobebarelynoticeableandshouldnotbeuncomfortable.someresearchershavetheorisedthatthepulsingmayactuallydecreasepainassociatedwithstandardortho-donticadjustmentsSCIENTIFICEVIDENCE

SutureGrowthModulatedbytheOscillatoryComponentofMicromechanicalStrainSCIENTIFICEVIDENCESCIENTIFICEVIDENCESCIENTIFICEVIDENCESCIENTIFICEVIDENCESCIENTIFICEVIDENCESCIENTIFICEVIDENCESCIENTIFICEVIDENCESCIENTIFICEVIDENCECLINICALEVIDENCEAcceleDent™IncreasestheRateofOrthodonticToothMovement:ResultsofaRandomizedControlledClinicalTrialCLINICALEVIDENCECLINICALEVIDENCECLINICALEVIDENCECLINICALEVIDENCETheperimeterwasdefinedbytracingthelabiolingualcentersofeachtoothfromcaninetocanine.CLINICALEVIDENCECLINICALEVIDENCECLINICALEVIDENCECLINICALEVIDENCECLINICALEVIDENCECLINICALEVIDENCETheresultsoftherandomizedcontrolledclinicaltrialdemonstratethatAcceleDentcanincreasetherateoftoothmovementwhenusedinconjunctionwithconventionalorthodontics.UseofAcceleDentdidnotincreasetheriskofeitherrootresorptionCASEREPORT18yearoldmaleClassIIIcombinationortho&surgicalcaseCASEREPORTCASEREPORT9WeeksCASEREPORT5dayspostorthognathicsurgery(9monthsintotreatment&2monthsofdelaywithtravelsandparentsaway)CASEREPORT6.5weekspostsurgery46WeeksTotalTreatmentTimecorticotomy-assistedorthodontictreatment

(CAOT)

发展过程1893年Bryan提出骨皮质切开加速牙齿移动这一概念。1959年Kole等首先应用了骨皮质首先应用了骨皮质切开术结合根尖下截骨术，证实能够有效加快正畸牙齿的移动。2001年Wilcko等提出了牙周加速成骨正畸(periodontallyacceleratedosteogenicorthodontics,PAOO)的新理念，主要通过切开正畸牙牙根周围颊侧骨皮质至骨髓质深度，并在切开骨表面放置可吸收人工骨材料以增加骨量。理论基础骨块移动理论（boneblocktheory）：颌骨骨皮质切开加速正畸牙齿移动的理论基础早期在手术中于牙齿近远中颊舌侧骨板进行骨皮质切开，保留骨松质的连续性，通过根尖下截骨术连接骨皮质切口以形成完整牙骨块，他认为去除骨皮质阻力后，牙齿与周围骨块形成整体在正畸力作用下加速移动，即为骨块移动理论。理论基础局部骨加速现象（regionalacceleratoryphenomenondRAP）被认为是骨皮质切开术加速牙齿移动的根本原因，而不是骨块移动理论。理论基础局部骨加速现象（regionalacceleratoryphenomenondRAP）为术后局部骨质产生的暂时性脱矿与再矿化表现为:在骨组织创伤后术创附近的牙槽骨进入短暂可逆的骨质减少状态，骨吸收及溶骨现象随即出现;在这一分解代谢的过程中骨密度虽然降低，但牙槽骨骨量并没有减少;正畸力施加使得牙根周围骨基质及骨胶原软组织基质随之移动;在随后的再矿化过程中新骨沉积，类骨质基质再矿化，重新包绕牙根周围。骨皮质切开术后一段时间可以加快正畸牙齿移动的速度，而该过程是基于引发现象后牙槽骨吸收和重建过程（RAP）.临床应用解除拥挤矫正上前牙唇倾，加速前牙内收，改善前突面型骨性三类错合畸形下前牙舌倾的去代偿个别牙齿的错合畸形也有很好的疗效，压低伸长磨，牵引埋伏牙，根骨黏粘牙齿解除后牙反牙合

LowerIncisorRetractionwithaModifiedCorticotomy

AngleOrthodontist,Vol76,No5,2006Inthecurrentcasereport,thetotalorthodontictreat-me