Periodontal Accelerated Osteogenic Orthodontics: A Description of the Surgical Technique

Elevation of a full-thickness mucoperiosteal flap alone accelerates orthodontic tooth movement

“…Although the Wilcko brothers report faster tooth movement, their conclusions are drawn from case studies without controls. [60][61][62] A randomized clinical trial that assessed the effect of corticotomy on tooth movement was performed by Fischer in 2007. 63 It pertained to six consecutive patients with bilateral palatally impacted canines.…”

Periodontally Accelerated Osteogenic Orthodontics: A Review of the Literature

“…33 Case Selection and Treatment Planning Case selection and treatment planning are the mutual tasks of the orthodontist and the surgeon as the orthodontist determines the OTM plan, identify the teeth to provide anchorage and arch segments to be expanded or contracted while the surgeon considers the clinical periodontal status, mucogingival structure, options for minimally invasive surgery and incorporation of aesthetic needs of the patient into the treatment plan. 33,38 Orthodontic bracketing and activation of arch wires should be performed no later than two weeks postoperatively to take the full advantage of the limited time of RAP occurrence. If required, as common in Class II malocclusions requiring retraction, anchorage must be established before the initiation of PAOO ™ procedure.…”

“…38 As coronal aspect of the flap is full-thickness, a split-thickness approach in apical portions might be preferred to provide closure with minimal tension. Mesial and distal extensions are suggested to avoid the need for vertical releasing incisions.…”

“…Interdental tissues regarding palatal or lingual gingival collars should be preserved in minimum and a tunnelling approach should be performed in maxillary central incisors area to enhance vascular supply and aesthetic outcome. 33,38,13 Decortication is performed on both labial and palatal (lingual) aspects of the alveolar bone to initiate the RAP, without creating movable segments of bone. Typically, vertical corticotomies in mid-interdental areas are connected with circular corticotomies.…”

“…A high-speed hand piece or a piezosurgical knife might be used in regard to general principles of bone surgery and local anatomic structure. 43,38,19 Bone grafting is commonly required in corticotomy areas. Predicted direction and amount of OTM and architecture of the existing alveolar bone in regard to buccolingual dimension and the need for labial support dictates the volume of the material to be used.…”