Corticision: A Flapless Procedure to Accelerate Tooth Movement

Orthodontic tooth movement results from applied forces to the teeth evoking cellular responses in the teeth and their surrounding tissues, including the periodontal ligament, alveolar bone and gingiva. It is advantageous for the orthodontist to be well informed of the detailed process of the biological events that unfold during tooth movement, since some of these details may differ from one person to another due to biological differences such as periodontal metabolism or alveolar bone density. This led us to emphasize that orthodontics is a field of endeavor where the integration of mechanics and biology is materialized, and to affirm the fact that tooth movement is conducted in individual human beings, each composed of a unique and intricate physiological system. Biological variations may be the foundation of the differences that are frequently observed in the outcomes of orthodontic treatment in particular with reference to treatment duration between patients with similar malocclusions and who were treated identically. A wide diversity of clinical trials has been carried out to control the tissue resistance to facilitate orthodontic tooth movement, which involves biomechanical, pharmaceutical, surgical, electrical regimens or tissue engineering technology. The term 'Corticision' is a neologism which indicates 'cortical bone incision'. It is a minimally invasive periodontal procedure without flap elevation, thus accelerating tooth movement with an enhanced turnover rate of the surrounding structures. This chapter introduces the technical procedure, and the biological background of how such a minor surgical procedure can receive the accelerated tooth movement with impunity and thereby shorten the duration of treatment.