A Comparison between Osteotomy and Corticotomy-Assisted Tooth Movement

Osteotomies and corticotomies used in combination with orthodontic tooth movement can activate different bone responses that may be exploited to accelerate tooth movement. Segmental osteotomies around dental roots can create a tooth-bearing transport disk that may be distracted and positioned with orthodontic appliances and archwires. In difficult craniofacial repairs, alveolar segments can be guided into position with archwires and orthodontic mechanics. The corticotomy extending into the marrow space can activate bone injury repair mechanisms that accelerate bone turnover as the alveolar bone surrounding the dental roots transitions from a demineralization phase to a fibrous replacement phase and, finally, a mineralization phase. The controlled demineralization and replacement of alveolar bone provides a window of opportunity for roots to move though less dense bone prior to remineralization. Although the corticotomies and osteotomies are minor surgeries compared to orthognathic surgery, the goal of future research is to produce similar bone responses by using smaller surgeries or by eliminating the surgeries altogether.