Periodontally Accelerated Osteogenic Orthodontics (PAOO) Using Platelet‐Rich Fibrin Alone: A Modified Approach With a 3‐Year Follow‐Up

Abstract

IntroductionOrthodontists are reportedly seeing more adult patients in their practices. Hence, it becomes increasingly important to evaluate the periodontium for any existing problems or potential issues that could be caused by orthodontic treatment. Periodontally accelerated osteogenic orthodontics (PAOO) is a method of surgically assisted tooth movement achieved through a combination of corticotomy and bone grafting allowing rapid tooth movement and decreased treatment time. Platelet‐rich fibrin (PRF) is shown to have osteoinductive effects along with enhanced soft and hard tissue healing outcomes. The aim of this case report is to describe a variation of the PAOO technique using PRF membranes alone and provide a proof of concept for the effect of PRF on soft and hard tissue healing outcomes when used with PAOO.Case PresentationA 43‐year‐old female expressed displeasure over her malaligned lower anterior teeth and difficulty performing oral hygiene in that area. Clinical examination showed inadequate keratinized tissue, and cone‐beam computed tomography (CBCT) images revealed extensive loss of buccal bone. Ultrasonic buccal corticotomies were made using a piezoelectric device from the alveolar crest extending past the tooth apices in the lower anterior region. Five PRF membranes were placed over the teeth and secured with sutures.ConclusionsThree‐year follow‐up showed exceptional improvement in soft tissue appearance and keratinized tissue width. CBCT images revealed no further loss of buccal bone. This is the first case to demonstrate that PAOO using PRF can be a viable option for orthodontic movement of periodontally compromised teeth.