矯正歯科治療における口腔インプラントの応用

抄録

　Orthodontic treatment of patients with periodontal disease has been difficult due to the lack of a source of anchorage to which orthodontic force can be applied．However，osseointegrated implants have become popular as a safe and reliable tool，not only for the treatment of a missing tooth but also for other purposes，including the use of osseointegrated implants to reposition natural teeth．We report here two patients in whom an osseointegrated implant was placed into the alveolar bone and used in orthodontic treatment．The oral implant was immobile by definition．Case 1 had maxillary and mandibular protrusion，a mandibular molar defect，and periodontal disease．After treatment of her periodontal disease，an osseointegrated implant was placed．Seven months later，the patient received orthodontic treatment using the implant as the source of anchorage．After 29 months of orthodontic treatment，the patient is satisfied with the improvements in her initial complaints of difficulty in mastication， dysfunction of the masticatory system， difficulty in closing the lips，and aesthetic dissatisfaction．Case 2 was a patient with anterior crossbite reversed occlusion，a molar defect，and periodontal disease．After treatment of the periodontal disease and bite-raising by temporary restoration for 2 months，an oral implant was placed．After the 6-month healing period，the patient received orthodontic treatment for 24 months．After the 6-month retention，the final prosthesis was placed using hybrid ceramics．The problem with difficulty of mastication has improved，and the patient is greatly satisfied with the treatment．In both patients who received orthodontic treatment using an oral implant as the source of anchorage，the oral implant did not move or looser． Oral implants may be useful in orthodontic treatment of patients who have no source of anchorage．