Esthetic region space closure using crestal and buccal corticotomy: A case report

Abstract

Aim and objective: Esthetic region space closure using crestal and buccal corticotomy applying the concept of periodontally accelerated osteogenic orthodontics (PAOO). Background: The concept of corticotomy-mediated orthodontics helps in rapidly moving teeth with minimal effects on the periodontium and reduces the treatment time. The approach toward treating anterior space closure using buccal corticotomy has been in practice, in the present case report we have included the same fundamental concepts of corticotomy and additionally introduced a crestal corticotomy. Periodontally accelerated osteogenic orthodontics is a surgical technique to create corticotomy which helps to reduce the density of the bone and increases the turnover of tissues adjacent to the surgical site, this decrease in the bone density and increase in the bone turnover helps to facilitate the orthodontic tooth movement. Case description: A patient aged 24 years/male undergoing orthodontic treatment for closure of open spaces in the anterior region, reported with open space between the lateral incisor and canine in the maxillary region, although the treating orthodontist attempted closure using various techniques by sliding mechanism using active tie back and NiTi closed coil spring for 6 months and when the space did not close further attempts were made using non-sliding mechanics with the help of omega loops, the results were negative. The patient was referred to the periodontics department wherein the case was evaluated and surgical correction using PAOO techniques was planned, following the treatment plan the procedure was completed successfully without any complication, and subsequently, 1–2-week follow-up was done the surgical site healing was satisfactory and the sutures were removed, following which the patient was referred to the orthodontist for activation of space closure by NiTi closed coil spring 9 mm delivering the light force of 150 g. Conclusion: The results of the procedure were satisfactory healing of the surgical site and there was no complication like pocket formation, recession, or loss of interdental papilla and on activation of NiTi closed coil spring the space closure was achieved. Clinical significance: The intervention of periodontal surgery by crestal and buccal corticotomy helps to achieve space closure within a short duration with minimal complication. The decrease in bone density and increase in bone turnover helps to facilitate the orthodontic tooth movement to achieve the desired results.