Abstract
BackgroundPeriodontally accelerated osteogenic orthodontics (PAOO) combines periodontal therapy with orthodontic therapy, which minimises treatment time. This study compared the effectiveness of a bovine-derived xenograft with that of bioactive glass when combined with PAOO for the treatment of adult patients with moderate crowding of the teeth.MethodsIn this prospective, single-masked clinical trial, 33 orthodontic patients (20 women, 13 men; mean age 21.2 ± 1.43 [18 − 27] years), were randomly allocated to one of three groups. Group 1 underwent a modified corticotomy technique on the labial side only, whereas group 2 was treated with the same technique combined with PAOO using a bovine-derived xenograft and group 3 was treated in the same way but combining PAOO with bioactive glass. The total treatment duration was recorded from the start of active orthodontic treatment, immediately after corticotomy, and at the time of debonding. Probing depth was evaluated clinically and bone density and root length were evaluated radiographically on the day of surgery (baseline, T1), post-treatment at debonding (T2), and 9 months post-treatment (T3).ResultsThe duration of orthodontic treatment was markedly reduced to an average of 11.4 ± 0.14 weeks in all groups. All probing depths were < 3 mm, the interdental papillae were well preserved, there was no loss of tooth vitality, and there was no evidence of significant apical root resorption at any time interval. All groups showed a decrease in mean bone density at T2 followed by an increase at T3. The net percentage change that occurred between baseline and 9 months post-treatment was significantly different between the three groups. Groups 2 and 3, where grafts were incorporated, demonstrated a statistically significant greater increase in bone density than group 1 at T3.ConclusionCombination of orthodontic treatment and periodontal surgery is an effective treatment for adult patients that decreases the duration of active treatment and reduces the risk of root resorption. Use of a bovine-derived xenograft with modified corticotomy provided superior benefits in terms of increased bone density than did the use of bioactive glass.Trial registrationThe study was retrospectively registered at ClinicalTrials.gov under Clinical Trial Registration Number: NCT02796911.
Highlights
Accelerated osteogenic orthodontics (PAOO) combines periodontal therapy with orthodontic therapy, which minimises treatment time
The total treatment time was calculated in weeks from the time of activation of the orthodontic appliance immediately following the corticotomy procedure to the time of debracketing
Clinical parameters Probing depth There was no significant difference in probing depth (PD) at baseline between the three groups (P > 0.05; Table 1)
Summary
Accelerated osteogenic orthodontics (PAOO) combines periodontal therapy with orthodontic therapy, which minimises treatment time. Moderate or severe crowding has been treated without extraction by corticotomy/osteotomy-assisted orthodontics, and in shorter time periods [5, 6]. It has been reported that this approach was efficient for reducing the treatment time to as little as a quarter of that usually required for conventional orthodontics [5, 7,8,9]. Additional applications for this technique have reportedly facilitated several orthodontic modalities in a short period of time, with greater post-orthodontic stability [7, 10]
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