J Oral Maxillofac Surg

67:2130-2148, 2009

Speedy Surgical Orthodontic Treatment

With Skeletal Anchorage in Adults—Sagittal
Correction and Open Bite Correction
Kyu-Rhim Chung, DMD, PhD,* Masaharu Mitsugi, DDS, PhD,†
Baek-Soo Lee, DDS, PhD,‡ Takahiro Kanno, DDS, PhD,§
Won Lee, DDS, PhD,¶ and Seong-Hun Kim, DMD, PhD储

Purpose: The present report describes a new type of corticotomy-assisted orthodontic treatment called
Speedy orthodontics, which allows faster movements of the dental segments using skeletal anchorage.
Materials and Methods: To minimize the risk of necrosis, 2 procedures are performed. During the
initial surgery, bilateral and horizontal corticotomies are performed in the palatal area with the patient
under local anesthesia. After 2 to 3 weeks, a second buccal corticotomy is performed and 500 to 900 g
of force per side is immediately applied to the corticotomized segment.
Results: Successful alveolar bone bending can be obtained in cases of adult protrusion or open bite.
Conclusions: Speedy orthodontics allows for more precise control of anterior segment retraction in
adult protrusion patients and can be used for posterior segment intrusion. This technology is powerful,
easy to apply, and provides a significant advance in surgical orthodontics.
© 2009 American Association of Oral and Maxillofacial Surgeons
J Oral Maxillofac Surg 67:2130-2148, 2009

Adult patients with protrusion needing anterior re- adult bimaxillary protrusion can be limited.4 Anterior
traction are at risk of various complications during segmental osteotomy makes it possible to avoid the
conventional orthodontic treatment, including mar- potential complications and shorten the treatment
ginal bone loss, root exposure, root resorption, and times (Fig 2).5-7 However, the side effects associated
prolonged treatment times (Fig 1).1-3 Depending on with osteotomies, such as loss of tooth vitality, avas-
the specific characteristics of the anterior alveolar cular necrosis of the bony segment, and general an-
bone, the ability to remodel bone when retracting esthesia risks, must be considered.8

*President of the Korean Society of Speedy Orthodontics.

†Chairman, Division of Oral and Maxillofacial Surgery, Kagawa Speedy Orthodontics
Prefectural Central Hospital, Kagawa, Japan.
Speedy orthodontics is defined as corticotomy-facili-
‡Professor, Department of Oral and Maxillofacial Surgery, Kyung
tated orthodontic treatment that combines corticotomy
Hee University School of Dentistry, Seoul, South Korea.
and orthopedic force application.9-12 It generates com-
§Clinical Fellow, Division of Oral and Maxillofacial Surgery, Ka-
pression osteogenesis in the corticotomized segment
gawa Prefectural Central Hospital, Kagawa, Japan.
during orthopedic traction (Fig 3). Kawakami et al13
¶Associate Professor, Division of Oral and Maxillofacial Surgery,
observed histologic changes in the cortical layer and
Department of Dentistry, The Catholic University of Korea, Ui-
jongbu St. Mary’s Hospital, Uijeongbu, Gyeonggi-do, South Korea.
minimal changes in spongeous bone when the max-
储Assistant Professor, Division of Orthodontics, Department of
illary anterior segment was retracted backward after
Dentistry, The Catholic University of Korea, Uijongbu St. Mary’s
corticotomy. Yoshikawa14 suggested that corticoto-
Hospital, Uijeongbu, Gyeonggi-do, South Korea. mies, along with orthopedic level forces, are efficient
Address correspondence and reprint requests to Dr Kim: Divi- for maxillary retraction. Their experimental animals
sion of Orthodontics, Department of Dentistry, The Catholic Uni- were subjected to the equivalent of 1,500 to 1,800 g
versity of Korea, Uijongbu St. Mary’s Hospital, 65-1 Geumoh-dong, for human adults and did not exhibit soft tissue dam-
Uijeongbu, Gyeonggi-do 480-717 South Korea; e-mail: bravortho@ age. Kim15 found no resorption or irregularities of the
catholic.ac.kr; bravortho@gmail.com periodontal ligament in the teeth retracted using
© 2009 American Association of Oral and Maxillofacial Surgeons Speedy orthodontics. Using finite-element 3-dimen-
0278-2391/09/6710-0012$36.00/0 sional models of a human dry skull to evaluate corti-
doi:10.1016/j.joms.2009.07.002 cotomy-assisted retraction of the upper anterior teeth,

2130
CHUNG ET AL 2131

Chung et al16 showed that the stress distribution in

the anterior bone segment was concentrated in the
corticotomized area, with displacement of the seg-
ment and limited amounts of tipping movement of
the anterior teeth (Fig 4). Lee et al17 reported that the
upper incisors played a role as a handle to bend the
alveolar bone in the Speedy orthodontics group.

Surgical Procedures of
Speedy Orthodontics
The cut should be wide enough to prevent rapid
reunion of the sectioned cortical plates, which would

FIGURE 2. Surgical correction of protruded lip using ASO. A,

Intraoral view. B, Pretreatment lateral cephalogram. C, Post-treat-
ment lateral cephalogram.
Chung et al. Speedy Surgical Orthodontic Treatment. J Oral Max-
FIGURE 1. A, Schematic of patient with bimaxillary protrusion, illofac Surg 2009.
with thick cortical bone and thin alveolar bone around roots of
anterior teeth. B, Limited possibilities of orthodontic teeth movement
owing to thin alveolar bone, which increases risk of root exposure
make segment movement difficult (Fig 5).12 An inter-
and alveolar bone loss after conventional orthodontic treatment. val of 2 to 3 weeks should be allowed for healing and
Chung et al. Speedy Surgical Orthodontic Treatment. J Oral Max- revascularization between the buccal and palatal cor-
illofac Surg 2009. ticotomies and soft tissues. Patients can choose be-
2132 SPEEDY SURGICAL ORTHODONTIC TREATMENT

FIGURE 3. Schematic illustration of A, bending compression osteogenesis and B, C, sequence of anterior retraction using orthopedic traction
after perisegmental corticotomy. Reprinted, with permission, from Chung.9
Chung et al. Speedy Surgical Orthodontic Treatment. J Oral Maxillofac Surg 2009.

tween general or local anesthesia with sedation. The used to reposition the reflected flaps to their original
corticotomy is usually performed on an outpatient position using absorbable suture material.
basis with the patient under local anesthesia and in- The force used to retract the anterior segment after
travenous sedation using remifentanil with midazo- perisegmental corticotomy is routinely 500 to 900 g
lam or propofol. per side. The force is applied for approximately 4 to
6 months.12 The amount and speed of the segmental
PALATAL CORTICOTOMY retraction might depend more on the patients’ bone
The operation is performed on an outpatient basis quality than on the retraction force used. Even though
in 2 stages. After local anesthesia, bilateral vertical and conventional mini-implants or miniplates can be used
horizontal maxillary corticotomies are performed on for skeletal fixation, new types of skeletal anchorage
the palatal side between the first and second upper appliances called C-implants, C-tubes, or C-palatal plates
premolars during the first stage. It is performed on the are preferred for immediate orthopedic traction of the
vestibular side with a mucoperiosteum incision and anterior segments (Fig 9).18-22 The C-palatal plate, which
elevation at the alveolar ridge 3 mm above the apices consists of 2 titanium miniplates joined together in a
of the teeth (Fig 6). cross-figure, was developed for better skeletal anchor-
age in the palatal area21,22 (Fig 9).
BUCCAL CORTICOTOMY Dental segments (bending compression) can be
most rapidly retracted using corticotomy and the ap-
Two to 3 weeks later, a second-stage corticotomy is
plication of an orthopedic force with skeletal anchor-
performed on the buccal sides after the mucoperios-
age, combined with the regional acceleratory phe-
teal flap has been raised to visualize the area of the
nomenon (RAP) (Figs 9C-E).12
corticotomy to ensure concordance with the previ-
ously corticotomized region (Fig 7). The horizontal
corticotomy is performed from the apex of the pre- LOWER ANTERIOR CORTICOTOMY AND ANTERIOR
molar to the contralateral premolar site. Piezosurgery SEGMENTAL OSTEOTOMY
is used, combined with a No. 5 round bur (Figs 7B,C). In contrast to upper perisegmental corticotomies,
Its selective cutting action decreases the possibility of lower corticotomies with orthopedic traction are
soft tissue damage to the maxillary sinus membrane more limited because of the smaller amounts of can-
and root peridontium. The buccal and palatal corti- cellous bone available, the thicker cortical bone, and
cotomy areas are checked using cone-beam com- the complex appliance design necessary for lingual
puted tomography (Fig 8). Interrupted sutures are traction (Figs 10, 11).
CHUNG ET AL 2133

FIGURE 4. Three-dimensional finite element analysis showing stress distribution in A, cortical bone and B, trabecular bone on buccal side
during conventional orthodontic treatment. C, Three-dimensional finite element model of maxilla with corticotomy. Stress distribution in D,
cortical bone and E, trabecular bone on buccal side during perisegment corticotomy facilitated orthodontic treatment. Reprinted, with
permission, from Chung et al.16
Chung et al. Speedy Surgical Orthodontic Treatment. J Oral Maxillofac Surg 2009.

As an efficient alternative to lower corticotomy, apices, running vertically along the longitudinal axis
mandibular anterior segmental osteotomy (ASO) can of the first premolars. Using a bur greater than 2 mm
be performed in an office-based setting (Fig 12).2,23 in diameter, horizontal osteotomies are deepened and
Mandibular ASO is performed with either a low-speed extended from the buccal cortex through to, but not
handpiece and/or piezosurgery. The anterior seg- perforating, the lingual cortex. The first premolars are
ments are fixed with plates and screws and further extracted after their root surfaces can be identified
stabilized with an archwire immediately after surgery. following vertical osteotomies through the buccal
The surgical procedures for lower ASO are as follows. cortex. Using a freer elevator to protect the lingual
With the patient under intravenous sedation (mid- mucosa, the vertical osteotomies are performed with
azolam) and mandibular block anesthesia, the incision burs in the extracted sockets, removing the amount of
is made through the mucosa from the canine on 1 side bone necessary to achieve the planned setback. After
to the contralateral canine. Next, the flap is reflected completing the vertical osteotomy, the horizontal os-
inferiorly to an area below the premolar apices. The teotomy is completed through careful perforation of
osteotomy design courses horizontally, parallel to the the lingual cortex. The anterior segment is then frac-
occlusal plane and at least 3 mm inferior to the canine tured, repositioned, and fixed with a bone plate and
2134 SPEEDY SURGICAL ORTHODONTIC TREATMENT

FIGURE 5. A, Schematic illustration of vascular architecture in anterior maxillary region. Collateral circulation permitted anterior
maxillary interdental and subapical osteotomies without jeopardizing intraosseous and intrapulpal blood supply. Reprinted, with
permission, from Bell, Am J Orthod 57:158, 1970. B-D, Schematic illustration of design of perisegmental corticotomy for anterior
retraction. Width of corticotomy should be sufficient to allow segmental movement to be completed before the cortices contact.
Reprinted with permission from Chung.9
Chung et al. Speedy Surgical Orthodontic Treatment. J Oral Maxillofac Surg 2009.

screws. After the reflected flap has been repositioned ting. Upper perisegmental corticotomy and lower
and sutured, a pressure dressing is applied to the ASO were performed in 2 stages after the 4 first
lower lip to prevent postoperative swelling. premolars had been extracted. The upper anterior
Figure 12A shows a 3-dimensional computed to- segment was retracted for 4 months. The upper pos-
mography image taken after the maxillary anterior terior segment was then intruded using a C-palatal
corticotomy and mandibular osteotomy. Miniplates, plate, after which finishing was performed. The post-
titanium plates, or absorbable plates can be selec- operative orthodontic treatment was planned and
tively used (Figs 12B,C) for fixation. ASO achieved performed to obtain a functional occlusion with good
great improvement of the facial proportions and lip facial proportions within a period of 13 months. No
competence (Fig 13). remarkable complications, such as root resorption,
loss of tooth vitality, segmental malunion, or peri-
odontal healing problems, were observed during or
Case 1
after the 2-staged corticotomy (Figs 15, 16).
A 29-year-old man was diagnosed with Class III
molar deformity, a severe anterior open bite, and SPEEDY ORTHODONTICS FOR ANTERIOR OPEN
bimaxillary protrusion (Fig 14). The treatment was BITE CORRECTION
planned to correct these problems. The patient de- The corticotomy design for open bite correction is
sired rapid treatment time and in an office-based set- similar to the design used for retraction. The horizon-
CHUNG ET AL 2135

tal corticotomy, however, should be wider than the

vertical corticotomy (Fig 17).2,24 After the corti-
cotomy, surgical miniplates are placed buccally in the
posterior maxilla or zygomatic buttress, as well as in
the mid-palatal suture area. Kanno et al25 suggested
that compression osteogenesis is an osteoplasty tech-
nique based on distraction osteogenesis. Orthopedic
intrusion of the posterior segment allows rapid repo-
sitioning of the dental segments secondary to the use
of a corticotomy, the application of orthopedic force
with miniscrews, and RAP occurring during compres-
sion.24

Case 2
A 37-year-old man was referred with a severe Class
I anterior open bite, partially attributable to prenatal
amelogenesis imperfecta (Figs 18A-C). Treatment was
planned to correct the skeletal open bite in the pos-
terior maxillary molar region. Preoperative cephalo-
metric analysis showed that 6 mm of superior reposi-

FIGURE 7. Perisegmental buccal corticotomy performed 2 weeks

after first surgery. A, Buccal frenum can be preserved using a
tunneling technique (surgery design developed by Dr Lee). B, C,
FIGURE 6. A, Perisegmental corticotomy on maxillary palatal Piezosurgery was usually used, combined with No. 5 round bur. Its
area using No. 5 round bur. Incisive nerve and artery should be selective cutting action decreases possibility of soft tissue damage
spared. B, View immediately after surgery. in regions of maxillary sinus membrane and roots.

Chung et al. Speedy Surgical Orthodontic Treatment. J Oral Max- Chung et al. Speedy Surgical Orthodontic Treatment. J Oral Max-
illofac Surg 2009. illofac Surg 2009.
2136 SPEEDY SURGICAL ORTHODONTIC TREATMENT

time of the planned treatment. The overbite was 1.4

mm and the overjet 2.5 mm. Her occlusal and ceph-
alometric studies showed an Angle Class I occlusion
with severe bimaxillary anterior dentoalveolar protru-
sion. To correct the convex profile, corticotomy-facil-
itated orthodontics/compression osteogenesis was ac-
complished in the upper anterior segment, combined
with lower ASO and extraction of the 4 first premo-
lars, to correct the convex profile. A preoperative
cephalometric analysis and a model set up were used
to determine the specific treatment approach. No
preoperative orthodontic treatment was performed.
Soon after bonding and banding both arches, the first
premolars were extracted. Then, the initial corti-
cotomy was performed on the palatal side (the max-
illary 6 anterior teeth) using a round bur after a mu-
coperiosteal flap was raised. The treatment was
performed in 2 stages (Fig 20A). A bone-borne distrac-
tor (Cizeta Surgical, Bologna, Italy) positioned in the
center of the hard palate was used for posterior re-
traction of the anterior teeth. The mandibular anterior
teeth were retracted by ASO. Three weeks later, a
second corticotomy was performed on the maxillary
labial side with the same procedures as used on the
palatal side. To ensure concordance with the previous
corticotomy, the mucoperiosteal flap was raised on
the vestibular side to visualize the area of the corti-
cotomy (Fig 20B). Two days after the surgery, com-
pression osteogenesis was initiated with a bone-borne
distractor to retract the maxillary frontal dental osse-
ous segment at the rate of 1 mm/d. The spaces cre-
ated by the extractions were closed, and the corti-
cotomized maxillary dento/alveolar segment was
FIGURE 8. A, Axial and B, sagittal cone-beam computed tomog-
raphy views showing depth and width of corticotomy. retracted by the eighth day (Figs 20C,D, 21). The
Chung et al. Speedy Surgical Orthodontic Treatment. J Oral Max-
palatal distraction device was removed 3 months after
illofac Surg 2009. Speedy orthodontics treatment. Excellent facial pro-
portions and Class I occlusion were achieved (Figs 22,
23, 24) within a period of 13 months. Retention was
tioning was required to correct the anterior open bite maintained by upper and lower fixed retainers.
and achieve a harmonious facial profile (Fig 18C).
Two-staged corticotomies and placement of the an-
Discussion
chor plates were performed with the patient under
local anesthesia and intravenous sedation. Eight Several studies have described RAP during tooth
months after surgery and 6 months after orthodontic movement using corticotomies or alternative meth-
and prosthetic treatment, the occlusal result was ods.26-33 Analyzing the reported results of Wilcko et
functional and stable (Figs 18D-G). al,28 rapid tooth movements are associated with in-
creased regional bone turnover (RAP). Speedy orth-
odontics produces “bony block” movement owing to
Case 3 (Modified Speedy Orthodontics
the combined effects of the surface corticotomy, strong
Using Intraoral Distractor)
orthopedic forces, bone bending, and RAP.22,26,27 Using
A 32-year-old Asian woman with severe bimaxillary cephalometric analyses, Heo34 evaluated the soft and
protrusion was referred for treatment (Fig 19). Her hard tissue changes that occurred after perisegmental
chief complaint was poor facial esthetics caused by corticotomy and orthopedic retraction to determine
bimaxillary protrusion and an inability to close her the factors that caused the decrease in lip protrusion
lips without excessive strain. Conventional orthodon- in 24 adult female patients (average age 27.3 years).
tic treatment was rejected because of the excessive The results showed large and significant associations
CHUNG ET AL 2137

FIGURE 9. Occlusal photographs of A, initial stage of upper anterior segment retraction using C-lingual retractor and C-plate
mechanics and B, after 3-month retraction period. Lateral cephalograms taken C, before retraction, D, after 3 months of retraction, and
E, superimposition.
Chung et al. Speedy Surgical Orthodontic Treatment. J Oral Maxillofac Surg 2009.

between the amount of buccal corticotomy and the faction with the office-based surgery and related orth-
buccopalatal width after corticotomy. Recently, we odontic treatment (unpublished data).
surveyed 60 women who had undergone Speedy orth- Successful treatment depends on the application of
odontics (average age 28 years, range 22 to 39) and a heavy orthodontic force after the corticotomies.22
found that 52 (95%) of the 60 patients reported satis- Gradual repositioning and control of the segments
2138 SPEEDY SURGICAL ORTHODONTIC TREATMENT

FIGURE 10. Surgical procedure of mandibular corticotomy. A, B, Labial corticotomy. C, Lingual corticotomy.
Chung et al. Speedy Surgical Orthodontic Treatment. J Oral Maxillofac Surg 2009.

through the use of elastics is continued for 3 or 4 Possible, but rare, surgical complications of the
more weeks, terminating with ideal positioning of the procedure include hemorrhage, pain, damage to the
bone and teeth. root, nerve, artery, and flaps, perforation of the nasal

FIGURE 11. Lateral cephalograms of 40-year-old woman showing treatment changes from A, before treatment, B, 1 week after, C, 4 months
after, and D, 10 months after corticotomy.
Chung et al. Speedy Surgical Orthodontic Treatment. J Oral Maxillofac Surg 2009.
CHUNG ET AL 2139

FIGURE 12. A, Three-dimensional computed tomography image after maxillary anterior corticotomy and mandibular segmental osteotomy
(ASO). B, Titanium miniplate for surgical fixation. C, Absorbable miniplate for surgical fixation.
Chung et al. Speedy Surgical Orthodontic Treatment. J Oral Maxillofac Surg 2009.

mucosa, devitalization of teeth, paresthesia, or insuf- dating the teeth into a unit and taking advantage of
ficient cortical cuts.22-24 Incomplete cortical bone compression osteogenesis. Perisegmental corticotomy
cuts make it difficult to move the segment, increases and skeletal anchorage can be used as an alternative
the risk of root resorption, and can result in uncon- to orthognathic surgery. The procedure is routinely
trolled tipping of the anterior dentition during ortho- accomplished with local rather than general anesthe-
pedic traction. Consequently, the corticotomy must sia. The technique allows for precise control of ante-
be executed meticulously, precisely, and completely. rior segmental retraction in adult patients with pro-
Speedy orthodontics facilitates increased tooth move- trusion and posterior segmental intrusion in patients
ments and decreases the treatment time by consoli- with open bite deformities. This technology is pow-

FIGURE 13. Facial photographs and lateral cephalograms of 21-year-old woman A to C, before and D to F, after treatment.
Chung et al. Speedy Surgical Orthodontic Treatment. J Oral Maxillofac Surg 2009.
2140 SPEEDY SURGICAL ORTHODONTIC TREATMENT

FIGURE 14. Case 1. Pretreatment extraoral (A, B), lateral cephalogram (C ), and intraoral photographs (D-F ).
Chung et al. Speedy Surgical Orthodontic Treatment. J Oral Maxillofac Surg 2009.
CHUNG ET AL 2141

FIGURE 15. Case 1. Post-treatment extraoral (A-C ) and intraoral photographs (D-I ).
Chung et al. Speedy Surgical Orthodontic Treatment. J Oral Maxillofac Surg 2009.

FIGURE 16. Case 1. Lateral cephalograms showing progress of treatment. A, Before treatment, B, 1 week after upper anterior corticotomy
and lower ASO, C, 5 months after surgery, and D, 14 months after surgery.
Chung et al. Speedy Surgical Orthodontic Treatment. J Oral Maxillofac Surg 2009.
2142 SPEEDY SURGICAL ORTHODONTIC TREATMENT

FIGURE 17. A, B, Perisegmental palatal corticotomy for upper posterior segment intrusion. C, D, Perisegmental buccal corticotomy
performed 2 to 3 weeks after first surgery. It requires more extensive removal of cortical bone than distraction osteogenesis. E, Schematic
illustration of pure compression osteogenesis. Reprinted, with permission, from Chung.9
Chung et al. Speedy Surgical Orthodontic Treatment. J Oral Maxillofac Surg 2009.
CHUNG ET AL 2143

FIGURE 18. Case 2. A, B, Extraoral and intraoral preoperative photographs showing severe anterior open bite and amelogenesis
imperfecta. C, Preoperative lateral cephalogram. D, E, Extraoral and intraoral photographs taken 8 months postoperatively. F, Superimpo-
sition of central incisors and first molars after active compression at posterior maxilla before (black) and after (red) treatment. G, Post-treatment
lateral cephalogram.
Chung et al. Speedy Surgical Orthodontic Treatment. J Oral Maxillofac Surg 2009.
2144 SPEEDY SURGICAL ORTHODONTIC TREATMENT

FIGURE 19. Case 3. A-F, Pretreatment intraoral photographs.

Chung et al. Speedy Surgical Orthodontic Treatment. J Oral Maxillofac Surg 2009.
CHUNG ET AL 2145

FIGURE 20. Case 3. Treatment progress with Speedy surgical orthodontics. A, Palatal corticotomy. B, Buccal corticotomy. C, Intraoral
distractor activation. D, Immediately after activation.
Chung et al. Speedy Surgical Orthodontic Treatment. J Oral Maxillofac Surg 2009.

FIGURE 21. Case 3. A, Pretreatment and B, postoperative lateral cephalograms.

Chung et al. Speedy Surgical Orthodontic Treatment. J Oral Maxillofac Surg 2009.

FIGURE 22. Case 3. A-F, Post-treatment intraoral photographs. (Fig 22 continued on next page.)
Chung et al. Speedy Surgical Orthodontic Treatment. J Oral Maxillofac Surg 2009.
2146 SPEEDY SURGICAL ORTHODONTIC TREATMENT

FIGURE 22. (Cont’d)

Chung et al. Speedy Surgical Orthodontic Treatment. J Oral Maxillofac Surg 2009.

FIGURE 23. Case 3. A, Pretreatment facial photograph. B, Post-treatment facial photograph.

Chung et al. Speedy Surgical Orthodontic Treatment. J Oral Maxillofac Surg 2009.
CHUNG ET AL 2147

3. Miyajima K, Nagahara K, Lizuka T: Orthodontic treatment for a

patient after menopause. Angle Orthod 66:173, 1996
4. Handelman CS: The anterior alveolus: Its importance in limiting
orthodontic treatment and its influence on the occurrence of
iatrogenic sequelae. Angle Orthod 66:95, 1996
5. Proffit WR, White RP Jr: Who needs surgical-orthodontic treat-
ment? Int J Adult Orthodon Orthognath Surg 5:81, 1990
6. Bell WH, Jacobs JD, Legan HL: Treatment of class II deep bite
by orthodontic and surgical means. Am J Orthod 85:1, 1984
7. Park JU, Hwang YS: Evaluation of the soft and hard tissue
changes after anterior segmental osteotomy on the maxilla and
mandible. J Oral Maxillofac Surg 66:98, 2008
8. Lanigan DT, Hey JH, West HA: Aseptic necrosis following
maxillary osteotomies: Report of 36 cases. J Oral Maxillofac
Surg 48:142, 1990
9. Chung KR: Textbook of Speedy Orthodontics (ed 1). Seoul,
Jee-Sung Publishing, 2001
10. Chung KR, Oh MY, Ko SJ: Corticotomy-assisted orthodontics.
J Clin Orthod 35:331, 2001
11. Chung KR, Kim SH, Kook YA: Speedy surgical orthodontic
treatment with skeletal anchorage in adults, in Bell WH, Guer-
rero CA (eds): Distraction Osteogenesis of the Facial Bones.
Toronto, Ontario, Canada, BC Decker, 2006
12. Chung KR, Kim SH, Lee BS: Speedy surgical orthodontic treat-
ment using temporary anchorage devices as an alternative to
orthognathic surgery. Am J Orthod Dentofac Orthop, in press
13. Kawakami T, Nishimoto M, Matsuda Y, et al: Histologic suture
changes following retraction of the maxillary anterior bone
segment after corticotomy. Endod Dent Traumatol 12:38, 1996
14. Yoshikawa Y: Effects on corticotomy on maxillary retraction
induced by orthopedic force. J Matsumoto Dent Coll Soc 13:
292, 1987
15. Kim HS: Histologic Changes Following En Masse Retraction of
the Maxillary Anterior Teeth After Anterior Block Corticotomy
in Beagle Dogs: Thesis. Seoul, South Korea, Kyung Hee Univer-
sity, 2005
16. Chung AJ, Kim US, Lee SH, et al: A study on the pattern of
movement and the stress distribution during retraction of max-
illary incisors by 3-D finite element method. Korean J Orthod
37:98, 2007
17. Lee JK, Chung KR, Baek SH: Treatment outcomes of orthodon-
tic treatment, corticotomy-assisted orthodontic treatment, and
anterior segmental osteotomy for bimaxillary dentoalveolar
protrusion. Plast Reconstr Surg 120:1027, 2007
18. Jeon MS, Kang YG, Mo SS, et al: Effects of surface treatment on
the osseointegration potential of orthodontic mini-implant. Ko-
rean. J Orthod 38:328, 2008
19. Chung KR, Nelson G, Kim SH, et al: Severe bidentoalveolar
protrusion treated with orthodontic microimplant-dependent
en masse retraction. Am J Orthod Dentofac Orthop 132:105,
2007
20. Chung KR, Kim YS, Linton JL, et al: The miniplate with tube for
FIGURE 24. Case 3. A, Post-treatment lateral cephalogram and B, skeletal anchorage. J Clin Orthod 36:407, 2002
superimposition. 21. Chung KR, Kim SH, Mo SS, et al: Division 1 mal-occlusion
Chung et al. Speedy Surgical Orthodontic Treatment. J Oral Max- treated by orthodontic miniplate with tube. Prog Orthod
illofac Surg 2009. 6:172, 2005
22. Chung KR, Kook YA, Kim SH, et al: Malocclusion treated by
combining a lingual retractor and a palatal plate. Am J Orthod
Dentofac Orthop 133:112, 2008
erful, easy to apply, and a significant adjunct to tradi- 23. Kim SH, Lee KB, Chung KR, et al: Severe bimaxillary protrusion
with adult periodontitis treated by corticotomy and compres-
tional surgical orthodontics. sion osteogenesis. Korean J Orthod 39:54, 2009
24. Chung KR, Mitsugi M, Lee BS, et al: Speedy surgical orthodon-
tic treatment with skeletal anchorage in adults-open bite clo-
sure by intruding maxillary molars: 3D accelerated orthog-
References nathic and orthodontic surgery-office based, in Bell WH (ed):
1. Midgerr RJ, Shaye R, Fruge JF: The effect of altered bone Toronto, Ontario, Canada, BC Decker, in press
metabolism on orthodontic tooth movement. Am J Othod 80: 25. Kanno T, Mitsugi M, Furuki Y, et al: Corticotomy and compres-
256, 1981 sion osteogenesis in the posterior maxilla for treating severe
2. Melsen B: Limitations in adult orthodontics, in Melsen B (ed): anterior open bite. Int J Oral Maxillofac Surg 36:354, 2007
Current Controversies in Orthodontics (ed 1). Quintessence 26. Frost HM: The biology of fracture healing. Clin Orthop Relat
Publishing, 1991, pp 147-180 Res 248:283, 1989
2148 SPEEDY SURGICAL ORTHODONTIC TREATMENT

27. Suya H: Corticotomy in orthodontics, in Hosl E, Baldauf A seointegrated mini-implant for minor tooth movement. Am J
(eds): Mechanical and Biological Basics in Orthodontic Ther- Orthod Dentofac Orthop, in press
apy. Germany, Hutig, Buch Verlag, 1991, pp 207-226 32. Gwack C, Kim SS, Park SB, et al: The expression of MMP-1, -8,
28. Wilcko WM, Wilcko T, Bouquot TE, et al: Rapid orthodontics and -13 mRNA in the periodontal ligament of rats during tooth
with alveolar reshaping: Two cases reports of decrowding. Int movement with cortical punching. Korean J Orthod 38:187,
J Periodontics Restorative Dent 21:9, 2001 2008
29. Iino S, Sakoda S, Ito G, et al: Acceleration of orthodontic tooth 33. Park WK, Kim SS, Park SB, et al: The effect of cortical punching
movement by alveolar corticotomy in the dog. Am J Orthod on the expression of OPG, RANK, and RANKL in the periodon-
Dentofac Orthop 131:e1, 2007 tal tissue during tooth movement in rats. Korean J Orthod
30. Kim DH, Park YG, Kang SG: The effects of electrical current 38:159, 2008
from a micro-electrical device on tooth movement. Korean. 34. Heo HA: Cephalometric Evaluation Following Maxillary Ante-
J Orthod 38:337, 2008 rior Retraction by Corticotomy-Facilitated Orthodontics: The-
31. Kim SH, Jeong DM, Chung KR, et al: Clinical application of sis. Uijeongbu, Gyeonggi-do, South Korea, Catholic University
accelerated osteogenic orthodontics (AOO™) and partially os- of Korea, 2009