Accelerated orthodontic treatment
One of the main disadvantages of modern orthodontics is the long time that treatment takes. This leads to many patients, particularly adults, not wishing to undergo orthodontic treatment.
In recent years, new techniques have been developed, which we could put under the heading of “accelerated orthodontic treatment”. They are ancillary procedures or techniques that make it possible to increase the speed and effectiveness of the movement of the teeth, thus reducing treatment times.
One of these techniques consists of the installation, through a simple surgical procedure, of bone anchoring systems (plates and/or screws), which the orthodontist will use as a support for moving the teeth more effectively. One of the main disadvantages of the microscrews used to anchor the bone is that after a period of time subject to force they start to loosen.
Dr. Hernández Alfaro has designed a transalveolar screw, which runs from side to side along the bone where the teeth are located and that acts as a "beam" so that force can be applied to both ends without any risk of loosening. The design of transalveolar screw and its applications for train the upper molars in “moving upwards” were published in the Medicina y Cirugía Oral journal.
Another technique in accelerated orthodontic procedures is known as corticotomy. Corticotomy is based on a phenomenon known as RAP (regional acceleratory phenomenon), through which if cuts are made in the bone next to the teeth metabolic phenomena appear that temporarily “soften” the bone and make the movement of the teeth in it happen faster.
Corticotomy was made popular in the US by the Wilcko brothers in the last decade and it has proved effective in shortening treatment times. The disadvantage of this technique, however, is that the entire gum needs to be separated from the bone. It involves a fairly long, invasive operation and the post-operative period is painful for the patient. Thus, in a patient who needs to undergo orthodontic treatment, the benefits of the corticotomy is neutralised by the traumatic experience of the surgery.
Aware of this problem, at the Instituto Maxilofacial we have designed a technique for performing a minimally invasive corticotomy. The procedure consists of making small incisions (thus eliminating the need to remove the entire gum from the bone). Tunnels are driven through these incisions below the gum and cuts in the bone (corticotomies) are made with the help of an endoscope and piezoelectric instruments. The simplicity of this procedure makes it possible for it to be carried out under local anaesthetic in just a few minutes. The results of this technique were published by Dr. Hernández Alfaro in the Journal of Periodontology