Periodontally accelerated osteogenic orthodontics: Review on a surgical technique and a case report

Abstract

Modifying the balance between resorption and apposition through selectively injuring the cortical plate of the alveolus has been an approach to accelerate tooth movement and is referred to as periodontally accelerated osteogenic orthodontics. It has gradually gained popularity as an adjunct treatment option for adults, as routine orthodontic tooth movement is difficult and time consuming once the mineralization and maturation of the maxilla and mandible are complete. Case selection is a very important step in which both the orthodontist and the periodontist should agree upon the need for corticotomy. The periodontally accelerated osteogenic orthodontic technique described by Wilcko (2001) involves full thickness flap reflection labially and lingually. Selective alveolar decortications are performed in the form of vertical decortications cuts up to 0.5 mm in depth, interdentally as well as horizontal cuts beyond the apex connecting the vertical decortications cuts. Adequate bio-absorbable grafting material is placed over the decortications site and sutured. Orthodontic tooth movement should start 1 or 2 weeks after the surgery. The present article reviews on contemporary clinical techniques in accelerated osteogenic orthodontics and a case report in which this technique has been implicated.Clinical Relevance to Interdisciplinary DentistryThe term interdisciplinary dentistry depicts the importance of team work. The combined effort of the specialists of the various branches of dentistry will help to deliver the best treatment to the patient by providing a well functioning dentition in a healthy periodontal environment. The present article highlights the importance of an interdisciplinary approach for the purpose of periodontally accelerated osteogenic orthodontics, in the treatment of adult orthodontic patients.