牙周加速成骨正畸技术辅助治疗骨性II类错牙合1例

目的 本病例报道1例改良的牙周加速成骨正畸（periodontally accelerated osteogenic orthodontics,PAOO）技术于骨性Ⅱ类错牙合畸形患者正畸正颌联合治疗中的辅助应用。诊治经过：在明确诊断及患者知情同意后,对患者进行正畸—正颌联合治疗。正畸去代偿前行改良的PAOO术式,包括保留龈乳头切口,全厚瓣翻开,牙根间骨皮质切开,填充骨移植材料但不放置屏障膜材料,以及改良的缝合方法。正畸去代偿后行正颌手术,且正颌术后进行术后正畸治疗。结果 PAOO术后17月,正畸去代偿结束时,临床疗效稳定,术区唇侧牙槽骨厚度增加,角化龈宽度增加,未见明显牙龈退缩及严重牙周炎症。结论 PAOO在正畸正颌治疗中的辅助应用能一定程度上改善患者的牙周表型,减少牙龈退缩、牙槽骨骨开窗、骨开裂等牙周并发症的风险。

Periodontally accelerated osteogenic orthodontic technique assisting in the treatment of skeletal class II malocclusion: A case report

Objective: This case reports the adjunctive application of the modified periodontally accelerated osteogenic orthodontics (PAOO) technique in the combined orthodontic and orthodontic treatment of skeletal class II malocclusion. Diagnosis and treatment: The patient received combined orthodontic and orthognathic treatment after a clear diagnosis and the patient's informed consent. And a modified PAOO procedure was performed before orthodontic decompensation, including a papilla preservation incision, full-thickness flap reflection, interradicular corticotomy, alveolar bone argumentation with bone graft material but without barrier membrane, and a modified suturing technique. After orthodontic decompensation, orthognathic surgery was performed, and then postoperative orthodontic treatment was administered. Results: At the end of orthodontic decompensation, seventeen months after PAOO, the clinical effect was stable, the thickness of the labial alveolar bone and the width of keratinized gingiva increased. Meanwhile, there was no obvious gingival recession and severe periodontitis. Conclusions: The adjunctive application of PAOO in orthodontic therapy can improve patients’ periodontal phenotype and reduce the risk of periodontal complications such as gingival recession, alveolar bone fenestrations and dehiscences.