Segmental Corticotomy-Assisted Orthodontic Treatment With Platelet-Rich Fibrin Augmentation of Class III Anomaly

This clinical report presents the outcomes of segmental corticotomy-assisted orthodontic treatment in a class III patient. A 13.5-year-old female patient presented with class III anomaly and a thin alveolus in the mandibular anterior region. After the alignment of the mandibular incisors, segmental corticotomy with platelet-rich fibrin (PRF) was performed in the mandibular incisor area to facilitate incisor retraction to ensure periodontal support after the changes in the inclination of the teeth. Lateral cephalograms were taken at the beginning (T0), precorticotomy (T1), at the end of the treatment (T2), and 2 years after the treatment (T3). Cone-beam computed tomography (CBCT) records were collected at the T1, T2, and T3 periods to evaluate the bone structures. The measurements included the inclination and the position of the mandibular incisors, symphysis width, symphysis height, B-B' width, cervical alveolar width, the vertical alveolar bone level on the labial and the lingual sides, and the amount of labial and lingual bone at the apex in the mandibular central incisor and canine areas.The class I molar and canine relationship was achieved in this borderline case. The amount of labial bone at the root apex and the B-B' width increased. A vertical alveolar bone gain was observed. The facial profile was improved significantly. The treatment outcome was stable at the 2-year follow-up. The segmental anterior mandibular corticotomy provided an effective correcting inclination of the mandibular teeth with the use of class III elastics. This technique ensured the maintenance of a sufficient amount of labial bone with no periodontal side effects.