Efficiency and Treatment Outcome of Corticotomy Assisted Orthodontics

Bimaxillary protrusion is a condition warranting retraction of upper and lower incisor for optimizing their axial inclination to obtain lip competency and for straightening the profile. These cases generally require maximum conservation of anchorage since the entire retraction space must be utilized for retracting the incisors. Further adults who have bimaxillary proclination often express a desire to expedite the duration of treatment. In recent times corticotomy has been reported to be a viable proposition especially in adults who are desirous of reduced treatment duration. Most of the currently used corticotomy procedure has to be done under conscious sedation or general anesthesia and many of these techniques are invasive. The challenge in treating bimaxillary case is during retraction stage wherein the anchorage can be severely taxed, in addition this stage requires protracted treatment time. The current study employed a modified corticotomy protocol which utilizes the principle of Regional acceleratory phenomenon, in addition Demineralized freeze dried bone was also used to augment the periodontal apparatus. The current modification is relatively simple, less invasive and can be done under local anesthesia as an outpatient procedure. Extraction of premolars just prior to retraction in our approach also provides for maximum space for retraction of incisors. The aim of the study was to compare the space closure in adults with modified corticotomy assisted orthodontic protocol and compare the treatment outcome in patients with similar malocclusion where corticotomy was not employed. The results conclusively prove that modified corticotomy procedure utilizing selective alveolar decortication is effective for retraction,reduces the retraction time by half in addition to conserving anchorage