To shorten the treatment period for maxillary protrusion in adults, we moved the upper anterior alveolar segment posteriorly en bloc by compressive osteogenesis using skeletal anchorage combined with corticotomy.
The operation was performed in two stages. In the first operation corticotomy of the palate bone was performed at the first or second premolar region. In the second operation, corticotomy of the labial side alveolus and fitting of the anchor plate were performed, and with compression beginning about two weeks later. Also, the distal segment was compressed using skeletal anchorage posteriorly, and superiorly.
A 19-year-old female with maxillary protrusion was treated by this method. After retraction started, posterior movement of the anterior segment was observed after about 3 months. The treatment period for the maxilla was about 12 months.
The advantages of this method include, 1) operation under local anesthesia is possible, 2) the blood supply to the bone segment is maintained, 3) the treatment period can be greatly shortened, 4) it is possible to operate in parallel with the orthodontic treatment, 5) the operative method is simple and the invasiveness of surgery is reduced, 6) the possibility of necrosis of pulp is low, and 7) anchor loss of molar can be prevented by using skeletal anchorage.
The demand for orthodontic treatment for adults will likely continue to increase in the future, and surgically assisted orthodontics in adult patients with various restrictions is a useful treatment.
