促进正畸治疗的牙周手术策略——浅谈牙周辅助加速成骨正畸术的临床应用

Strategies of periodontal surgery to promote orthodontic treatment:the clinical application of periodontally accelerated osteogenic orthodontics

正畸移动牙齿与牙周支持组织的健康密切相关,牙周-正畸联合治疗模式已日趋常态化。炎症控制是牙周炎患者正畸治疗的前提,疗程长以及牙周组织在正畸过程中受损的风险已逐渐引起重视。牙周辅助加速成骨正畸(periodontally accelerated osteogenic orthodontics,PAOO)术是选择性牙槽骨骨皮质切开术联合骨移植材料促进正畸治疗的手术策略之一,它旨在通过骨皮质切开加速牙齿移动,缩短疗程,骨增量重塑牙槽基骨拓展牙齿移动范围,降低正畸过程中牙齿移出牙槽骨边界的风险。本文在文献回顾的基础上,阐述如何设计实施以使PAOO术的效用最大化。

Orthodontic moving teeth are closely related to the health of periodontal support tissues,and the combined periodontal orthodontic treatment is becoming more and more normalized.Inflammation control is the prerequisite for orthodontic treatment in patients with periodontitis.For many adult patients,the long course of treatment and the risk of periodontal tissue damage during orthodontic treatment have gradually attracted the clinicians′attention.Periodontally accelerated osteogenic orthodontics(PAOO)is one of the surgical strategies by combining selective decortication with alveolar augmentation to promote orthodontic treatment.It is aiming to accelerate the movement of teeth for shortening the treatment course,to increase the bone volume for reshaping the alveolar bone and expanding the range of tooth movement and to reduce the risk of tooth movement beyond the"alveolar bone boundary"during orthodontic treatment.Based on the retrieve and review of current literature,this article will focus on how to design and implement PAOO surgery so as to maximize the effectiveness in clinical practice.