Periodontally accelerated osteogenic orthodontics

Abstract

This case report demonstrates an orthodontic method that offers short treatment time and the ability to simultaneously reshape and increase the buccolingual thickness of the supporting alveolar bone. A 23-year-old female with Angle’s Class I moderately to severely crowded malocclusion with periodontal pocket with 31 and reduced thickness of the buccal cortical plate of lower anteriors, requested shortened orthodontic treatment time. This surgery technique included buccal full-thickness flaps, selective partial decortication of the cortical plates, concomitant bone grafting/augmentation, and primary flap closure. Following the surgery, orthodontic adjustments were made approximately every 2 weeks. From bracketing to debracketing, the case was completed in approximately 7 months and 3 weeks. Posttreatment evaluation of patient revealed good results. Preexisting thin labial bony cortical plate with lower anteriors was covered. This finding suggests credence to the incorporation of the bone augmentation procedure into the corticotomy surgery because this made it possible to complete the orthodontic treatment with a more intact periodontium. The rapid expansive tooth movements with no significant apical root resorption may be attributed to the osteoclastic or catabolic phase of the regional acceleratory phenomenon.