Alessandro Mario Greco 先生 イタリア
講演・研修イベント
第5回 日本アライナー矯正歯科研究会 (2018)
- Anchorage Modulation with MOPs & TADs for optimized Aligner Digital Orthodontics
- ＜最適化されたアライナー矯正治療：MOPとTADによるAnchorage Modulation＞
アライナー矯正装置に補助的装置を併用することで歯槽骨に刺激を与え、複雑な歯の動きが可能になることが最近話題になっている。歯の移動中にBone envelopeを調整することで固定源をとりやすくすることは新しい概念ではないが、細胞を直接刺激する装置（振動・光・穿孔）は日々の治療に取り入れら易くなった。マイクロオステオパーフォレーション(MOP)のみ、あるいはTADと併用することは固定源が必要なポイントに骨に刺激を与えて固定源を細かく調整することに最適な選択肢だろう。近遠心的に歯の移動を行う際（遠心移動・近心移動・抜歯）MOPを第二大臼歯の近遠心位だけに適用することで固定源が必要な箇所以外の歯槽骨を歯が動きやすい状態にさせることができる。このようにサイトカイン細胞反応が歯列弓全体ではなく、固定源の位置が変わるたびに、その箇所だけに起こすことになる。歯槽骨の段階的な調整はアライナー矯正治療をより単純にし、最適化で推測可能な歯移動計画を立案しやすくするであろう。
The possibility to facilitate orthodontic complex movements by means of external auxiliary devices stimulating the bone, represents nowadays one of the most discussed trend in Orthodontics. The concept of modulating the bone envelope in order to simplify the anchorage during dental movements is not new, but the opportunity to do it with more handle devices exerting different level of cellular stimulation (like vibrations, light or perforations) could be an option applied on a day base. The use of Micro Osteo Perforations alone or together with TADs could represent one of the best options to stimulate the bone and so to modulate orthodontic anchorage exactly in the are where a simplification of anchorage is needed. During the teeth movement over the arch perimeter (distalization, mesialization or extraction) applying MOPs in a specific area (only in the distal and mesial portion of second molars) it’s possible to create a more reactive bone envelope only where more facilitated movement is needed and to avoid stimulation in the area where anchorage is needed. In this way the cellular recall of cytokines is not all over the arch but precisely located during all treatment since the procedure could be repeated in different areas as the anchorage conditions change during treatment. This different step by step bone modulation could represent an interesting new option simplifying digital orthodontic treatment with aligners achieving an optimized predictable tooth movement path.
Dr. Greco took his Dental Degree at University of Rome “Tor Vergata” in 1999, his Postgraduate Degree in Orthodontics at University of Ferrara in 2007, served as Postgraduate Fellow at San Giovanni Calibita Fatebenefratelli Hospital Isola Tiberina in Rome from 2000 to 2015, became PhD Doctor at University of Rome “Tor Vergata in 2016, Visiting Professor at University of Ferrara from 2013 and Visiting Professor at University of L’Aquila from 2017. He is Member of Italian Board of Orthodontics (I.B.O.), Member of European Board of Orthodontists (E.B.O.), Active Member of Italian Society of Orthodontics (S.I.D.O.), Active Member of Italian Academy of Orthodontics (A.I.d.Or.), Active Member of European Orthodontic Society (E.O.S.), Active Member of World Federation of Orthodontists (W.F.O.), Member of European Aligner Society (E.A.S.), Past-President (2013-15) of the Italian Society of Bidimensional Technique (S.I.Te.Bi), Past President (2013) of the Italian Association of Orthodontists Specialist (A.S.I.O.), Clinical Speaker Invisalign (2013) and Clinical Speaker GC Orthodontics. Author of scientific papers on national and international journals, speaker at nationals and international courses and meetings. He has got his own dental practice in Rome with exclusive interest to Orthodontics.
