Scope of treatment with periodontally accelerated osteogenic orthodontics therapy

Ferguson, Donald J.; Wilcko, M. Thomas; Wilcko, Willam M.; Makki, Laith

doi:10.1053/j.sodo.2015.06.004

Cited by 28 publications

(34 citation statements)

References 20 publications

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“…PAOO has been considered as an alternative treatment in some complicated cases. 1,2,[4][5][6] In this case report, one year following treatment, soft and hard tissue support improved clinically and radiographically. Wilcko et al using DFDBA and xenograph showed an increase in width of 2.4 mm in the buccal and 3.6 mm in the lingual plate.…”

Section: Discussionmentioning

confidence: 59%

“…Unfavorable dento‐alveolar anatomy may limit ideal tooth movement unless alternative orthodontic approaches are performed. Techniques such as PAOO have broadened the scope of treatment possibilities . This approach has provided opportunities to accelerate and facilitate tooth movement through corticotomy while simultaneously increasing the volume of alveolar bone …”

Section: Discussionmentioning

confidence: 99%

“…Periodontally accelerated osteogenic orthodontics (PAOO), which combines selective alveolar corticotomy, bone grafting, and orthodontic forces, has been used to increase alveolar bone volume, shorten treatment time, increase the scope of treatment, reduce root resorption, provide greater post‐treatment stability, and increase the height of the keratinized gingiva …”

Section: Introductionmentioning

confidence: 99%

“…3 Periodontally accelerated osteogenic orthodontics (PAOO), which combines selective alveolar corticotomy, bone grafting, and orthodontic forces, has been used to increase alveolar bone volume, shorten treatment time, increase the scope of treatment, reduce root resorption, provide greater post-treatment stability, and increase the height of the keratinized gingiva. 1,2,[4][5][6] Using acellular dermal matrix (ADM) to enhance soft tissue thickness simultaneously with PAOO has not been mentioned in the related studies; hence, the purpose of this case report was to evaluate clinical and radiographic outcomes of PAOO combined with soft tissue allograft.…”

mentioning

confidence: 99%

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A Novel Approach in Periodontally Accelerated Osteogenic Orthodontics (PAOO): A Case Report

Soltani

Loomer

Chaar

2018

Clin Adv Periodontics

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Introduction The purpose of this case report was to evaluate clinical and radiographic outcomes of periodontally accelerated osteogenic orthodontics (PAOO) combined with soft tissue enhancement in a patient with thin biotype and lack of buccal plate. Case Presentation A 46‐year‐old female was referred for periodontal risk assessment prior to orthodontic treatment. Following a comprehensive examination, including taking a cone beam computerized tomography (CBCT) the patient was identified as high risk for soft tissue recession because of prominent roots, lack of buccal plates, and thin soft tissue. The treatment was PAOO combined with soft tissue enhancement to improve hard and soft tissue support of anterior mandibular teeth. Conclusions Clinical and radiographic evaluation after one year revealed significant improvements in hard and soft tissue phenotype. In conclusion, combination of PAOO and soft tissue grafting could be a promising treatment to improve hard and soft tissue support for orthodontic patients.

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Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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A Novel Approach in Periodontally Accelerated Osteogenic Orthodontics (PAOO): A Case Report

Soltani

Loomer

Chaar

2018

Clin Adv Periodontics

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“…The anatomic limits of orthodontic tooth movement are set by the cortical plate of the alveolus at the level of the incisor apices and may be regarded as the “orthodontic walls” or, more recently, with a contemporary synonym of “orthodontic boundary conditions” . A previous review article presented PhMT‐b cases and evaluated the scope of tooth movement, and the authors concluded the anterior incisor relationship can be expanded beyond Proffit's envelope by an average of two‐fold . However, the predictability of such approach should be evaluated on an individual basis and caution should be taken when applying numbers to actual patient care.…”

Section: Discussionmentioning

confidence: 99%

Is periodontal phenotype modification therapy beneficial for patients receiving orthodontic treatment? An American Academy of Periodontology best evidence review

Wang

Mandelaris

et al. 2019

Journal of Periodontology

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Background Orthodontic treatment can greatly impact the periodontium, especially in dentitions with a thin periodontal phenotype. Orthodontic tooth movement can result into iatrogenic sequelae to these vulnerable anatomic conditions, such as development and exacerbation of bony dehiscence or fenestration defects, which can manifest loss of periodontal support and gingival recession (GR). This systematic review aimed to investigate whether periodontal phenotype modification therapy (PhMT) involving hard tissue augmentation (PhMT‐b) or soft tissue augmentation (PhMT‐s) has clinical benefits for patients undergoing orthodontic treatment. Methods An electronic search was performed in two major databases for journals published in English language from January 1975 to January 2019 and a hand search of printed journals was also performed to identify human clinical trials reporting clinical and radiographic outcomes of patients receiving orthodontic treatment with or without hard and soft tissue augmentation procedures. Data were extracted and organized into tables for qualitative assessment. Results Eight studies were identified evaluating the outcomes of PhMT in patients undergoing orthodontic therapy. Six studies evaluated patients receiving PhMT‐b via corticotomy‐assisted orthodontic therapy (CAOT) and simultaneous bone augmentation while the other two received PhMT‐s before tooth movement. No studies investigated PhMT‐b alone without CAOT and most studies focused on the mandibular anterior decompensation movements. There was high heterogeneity in the study design and inconsistency of the reported outcomes; therefore, a meta‐analysis was not performed. Evidence at this moment supports CAOT with hard tissue augmentation accelerated tooth movement. However, only two studies provided direct comparison to support that CAOT with PhMT‐b reduced the overall treatment time compared with conventional orthodontic treatment. No periodontal complications or evidence of severe root resorption were reported for both groups. Four studies provided radiographic assessment of the PhMT‐b and demonstrated increased radiographic density or thicker facial bone after the treatment. Two studies reported an expanded tooth movement. One study reported an increase in keratinized tissue width post‐CAOT plus PhMT‐b, while another study with a 10‐year follow‐up showed a lower degree of relapse using the mandibular irregularity index when compared with conventional tooth movement alone. Two studies examined the effect of PhMT‐s before orthodontic treatment. Unfortunately, no conclusions can be drawn because of the limited number of studies with contradicting outcomes. Conclusions Within the limited studies included in this systematic review, PhMT‐b via particulate bone grafting together with CAOT may provide clinical benefits such as modifying periodontal phenotype, maintaining or enhancing facial bone thickness, accelerating tooth movement, expanding the scope of safe tooth movement for patients undergoing orthodontic tooth movement. The...

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Surgical Considerations and Decision Making in Surgically Facilitated Orthodontic Treatment/Periodontally Accelerated Osteogenic Orthodontics

Mandelaris

Richman²,

Kao

2020

Clin Adv Periodontics

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Surgically facilitated orthodontic treatment (SFOT)/periodontally accelerated osteogenic orthodontics (PAOO) has the potential of allowing safer orthodontic treatment in vulnerable periodontium with thin phenotypes. SFOT/PAOO is a phenotype modification therapy (PhMT) approach where thin bone morphotype and/or gingiva are surgically augmented to convert a fragile-thin to a robust-thick periodontal environment. This permits orthodontic treatment in these previously thin phenotype cases to proceed without iatrogenically-induced adverse effects. This is an infrequently performed procedure with few available clinical recommendations.

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Scope of treatment with periodontally accelerated osteogenic orthodontics therapy

Cited by 28 publications

References 20 publications

A Novel Approach in Periodontally Accelerated Osteogenic Orthodontics (PAOO): A Case Report

A Novel Approach in Periodontally Accelerated Osteogenic Orthodontics (PAOO): A Case Report

Is periodontal phenotype modification therapy beneficial for patients receiving orthodontic treatment? An American Academy of Periodontology best evidence review

Surgical Considerations and Decision Making in Surgically Facilitated Orthodontic Treatment/Periodontally Accelerated Osteogenic Orthodontics

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