Periodontal Considerations of Orthodontic Molar Intrusion: A Review of Traditional Orthodontic Methods and Temporary Anchorage Devices

大臼齒內縮矯正之牙周考量：暫時錨定裝置與傳統矯正文獻回顧

顏嘉珍(Chia-Chen Yen) ； 董醒任(Tony Shing-Zang Dung) ； 石相懋(Hsiang-Mao Shih) ； 呂炫堃(Hsein-Kun Lu)

《臺灣牙周病醫學會雜誌》 16卷1期 (2011/03) Pp. 48-58

摘要

The present review discusses periodontal reactions related to molar intrusions: ＜1＞ the gingival response including pocket formation and keratinized gingival change in periodontally healthy patients; and ＜2＞ the effects of attachment gain, grade Ⅲ furcation lesions, and guided tissue regeneration (GTR) in periodontal compromised patients. Whether an orthodontic intrusion can induce or improve these problems by repositioning the teeth and/or increasing cellular activity is a relatively new issue. In addition, conventional orthodontic intrusion is usually accompanied by unfavorable actions and reactions of the anchorage teeth, so we also discuss the application of temporary anchorage devices (TADs) for increasing the feasibility of treatment and its simplification.As greater amount of intrusion is produced, further periodontal evaluation is suggested to determine if pathologic pockets have formed. No significant change in keratinized gingival width was shown. After waiting for more than 6 months subsequent to GTR, intrusion is practical treatment. Intrusion before GTR may have benefits. Although in animal studies, open flap debridement followed by orthodontic intrusion had significant benefits on furcation lesions, and new attachment formation was found at the initial periodontal defect level under good oral-hygiene control. However, most such effects mentioned above still lack corresponding human trials, and further studies with long-term follow-up are needed. TADs which mimic absolute anchorage are a relatively simple, safe, and effective method.

關鍵字

矯正內縮 ； 牙齦 ； 牙周炎 ； 新牙周附連 ； 暫時錨定裝置

並列摘要

The present review discusses periodontal reactions related to molar intrusions: ＜1＞ the gingival response including pocket formation and keratinized gingival change in periodontally healthy patients; and ＜2＞ the effects of attachment gain, grade Ⅲ furcation lesions, and guided tissue regeneration (GTR) in periodontal compromised patients. Whether an orthodontic intrusion can induce or improve these problems by repositioning the teeth and/or increasing cellular activity is a relatively new issue. In addition, conventional orthodontic intrusion is usually accompanied by unfavorable actions and reactions of the anchorage teeth, so we also discuss the application of temporary anchorage devices (TADs) for increasing the feasibility of treatment and its simplification.As greater amount of intrusion is produced, further periodontal evaluation is suggested to determine if pathologic pockets have formed. No significant change in keratinized gingival width was shown. After waiting for more than 6 months subsequent to GTR, intrusion is practical treatment. Intrusion before GTR may have benefits. Although in animal studies, open flap debridement followed by orthodontic intrusion had significant benefits on furcation lesions, and new attachment formation was found at the initial periodontal defect level under good oral-hygiene control. However, most such effects mentioned above still lack corresponding human trials, and further studies with long-term follow-up are needed. TADs which mimic absolute anchorage are a relatively simple, safe, and effective method.

並列關鍵字

intrusion ； gingiva ； periodontitis ； new attachment ； temporary anchorage device