Korean J Orthod.  2013 Dec;43(6):302-310. 10.4041/kjod.2013.43.6.302.

Alveolar ridge expansion-assisted orthodontic space closure in the mandibular posterior region

  • 1Department of Orthodontics, Faculty of Dentistry, Ondokuz Mayis University, Turkey. meteozer@yahoo.com
  • 2Department of Maxillofacial Surgery, Faculty of Dentistry, Ondokuz Mayis University, Turkey.


Orthodontic closure of old, edentulous spaces in the mandibular posterior region is a major challenge. In this report, we describe a method of orthodontic closure of edentulous spaces in the mandibular posterior region accelerated by piezoelectric decortication and alveolar ridge expansion. Combined piezosurgical and orthodontic treatments were used to close 14- and 15-mm-wide spaces in the mandibular left and right posterior areas, respectively, of a female patient, aged 18 years and 9 months, diagnosed with skeletal Class III malocclusion, hypodontia, and polydiastemas. After the piezoelectric decortication, segmental and full-arch mechanics were applied in the orthodontic phase. Despite some extent of root resorption and anchorage loss, the edentulous spaces were closed, and adequate function and esthetics were regained without further restorative treatment. Alveolar ridge expansion-assisted orthodontic space closure seems to be an effective and relatively less-invasive treatment alternative for edentulous spaces in the mandibular posterior region.


Tooth movement; Corticotomy; Adult treatment; Orthodontic treatment

MeSH Terms

Alveolar Process*
Orthodontic Space Closure*
Root Resorption
Tooth Movement


  • Figure 1 Pretreatment facial and intraoral photographs.

  • Figure 2 Panoramic radiographs showing the treatment progress. A, Pretreatment stage. B, The mandibular left second molar erupted into the oral cavity and maxillary fixed appliance therapy was started in the sixth month of treatment. C, Both the mandibular second premolars were moved mesially to close the spaces between the first and the second premolars bilaterally. D, Posttreatment stage.

  • Figure 3 Pretreatment lateral head film and cephalometric tracing.

  • Figure 4 Schematic of the corticotomy procedure. A, Sagittal view. B, Occlusal view.

  • Figure 5 Intraoperative phase. A, Corticotomy lines. B, Cylindrical bone-block placement. C and D, Postsurgical orthodontic mechanics.

  • Figure 6 Posttreatment facial and intraoral photographs.

  • Figure 7 Posttreatment lateral head film and cephalometric tracing.

  • Figure 8 Superimposition of the pretreatment (dotted line) and posttreatment (solid line) cephalometric tracings. A, Maxillary segmental superimposition. B, Mandibular segmental superimposition.


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