The clinical efficacy of deproteinized bovine bone mineral with 10% collagen in conjunction with localized piezosurgical decortication enhanced orthodontics: A prospective observational study

Abstract

Background Evidence exists on the clinical efficacy and safety of periodontally accelerated osteogenic orthodontics (PAOO) with “Piezocision”—a minimally invasive, flapless alternative to corticotomy for alveolar bone augmentation. Allograft has been extensively studied for alveolar bone augmentation in Piezocision; however, the use of deproteinized bovine bone mineral with 10% collagen (DBBM‐C) in Piezocision for PAOO has not been investigated. Methods This study is a prospective, observational, cohort study of 19 patients of Angle Class I malocclusion with a total of 692 teeth assessed for maintenance of health of the periodontal attachment apparatus. Patient‐centered pain, sensitivity, and satisfaction outcomes, digital photographs and radiographs, and changes in probing depth, clinical attachment level, width of keratinized tissue, percussion sensitivity, pulp vitality tests, radiographic pathology, and root‐crown‐ratio were all recorded. Results Overall treatment was significantly faster (5 to 7 days between clear aligner tray changes), periodontal parameters remained stable, and alveolar bone loss was not observed. Visual analog score for healing, sensitivity/duration, bleeding/duration, swelling/duration, appearance, and inflammation, demonstrated no significant differences between DBBM‐C and control (no bone graft) groups. Patient‐centered outcomes revealed high levels of satisfaction with Piezocision. Piezocision‐treated teeth with DBBM‐C tended to exhibit less root resorption, although it was not statistically significant (P = 0.074). Conclusions Within the limits of the study, our results show that the use of DBBM‐C with piezosurgically enhanced orthodontics is effective and safe. This study was not designed to demonstrate equivalence with other materials that might be used in Piezocision. To understand whether there is an advantage to using DBBM‐C, additional studies may be required.

The clinical efficacy of periodontally accelerated osteogenic orthodontics in patients with bone fenestration and dehiscence: a retrospective study

“…Thus, the average orthodontic treatment time for adults is 18.7 to 31 months duration, is usually attributed to hyalinizing necrosis of the periodontal ligament and commonly identified in adults [ 6 ]. However, significant root resorption was not identified in the current study, which was in accordance with previous findings [ 28 ]. Based on the current understanding, after PAOO surgery is performed, cortical incision initiates the RAP to reduce the resistance to tooth movement, leading to a decrease in the orthodontic treatment time and a reduction in root resorption.…”

“…In our current study, there were no significant differences in BI, PD or KGW (between baseline and 3, 6 and 12 months postoperatively). These findings were in line with a previous study conducted by Miyamoto T et al, in which periodontal parameters remained stable after the implementation of PAOO surgery supplemented with deproteinized bovine bone mineral with 10% collagen (DBBM-C) or without DBBM-C [ 28 ]. BI and PD are closely related to plaque biofilm and gingival inflammation; keratinization of the gingiva is of great significance because it enables periodontal tissues to resist external stimulation, and the ability to resist inflammation was identified to be positively related to KGW.…”

Effectiveness of platelet rich fibrin versus demineralized bone xenograft in periodontally accelerated osteogenic orthodontics:

“…19 The advantages of graft material in PAOO include lesser limitation on pre-existing dentoalveolar volume, reduction in the need for orthognathic surgery and faster treatment time. 17,20,21 The stability of the graft incorporated during PAOO remains one of the key features to the presence of RAP throughout the period of accelerated tooth movement. Though there are various studies 22,23 that have evaluated the efficacy of less invasive procedures to accelerate orthodontic tooth movement, conventional PAOO with incorporation of graft remains more effective due to the intensity of the surgical insult to the dentoalveolar region.…”

Effects of Concentrated Growth Factor on Gingival Thickness in Periodontal Accelerated Osteogenic Orthodontics: A 6-Month Randomized Controlled Trial

“…[8][9][10] For example, periodontally accelerated osteogenic orthodontics (PAOO) is a relatively new procedure that has been applied to increase alveolar bone volume, shorten treatment time, increase the scope of treatment, reduce root resorption, and provide greater post-treatment stability. [11][12][13][14][15] However, conventional PAOO using collagen matrix memberane could not increase the gingival thickness (GT). Patients with thin gingival phenotype are more likely to suffer a gingival recession after surgery.…”