The Impact of Platelet Rich Fibrin on Periodontally Accelerated Osteogenic Orthodontics (PAOO)-A Perio-Ortho Interdisciplinary Case Report

Abstract

Background: In the present day scenario as the number of adult patients presenting with severe teeth malocclusions increase, the orthodontic profession constantly debates on ways to accelerate tooth movement and focuses on improving the patient centered outcomes. PAOO, a surgically assisted orthodontic procedure, which combines the use of corticotomy along with bone grafts, has been used to fasten the clinical results. Platelet rich fibrin, (PRF), an autologous platelet concentrate, with its vast release of growth factors plays an important role in enhancing soft tissue outcomes. Aim: This case report aimed to demonstrate the efficacy of PRF on soft tissue outcomes when used as an adjunct to a variation of PAOO technique and also assess the time duration to achieve complete space closure. Case description: A 23 year old female patient had presented herself to the outpatient Department of Orthodontics, Manipal College of Dental Sciences, Mangalore, India, with a chief complaint of protruded upper anterior teeth. The patient had been diagnosed with Class 2 division 1 malocclusion, after which therapeutic extraction of upper 1st premolars and lower 2nd premolars were performed. To facilitate lower molar protraction, the patient was referred to the Dept. of Periodontology for PAOO procedure. PAOO procedure was performed along with PRF and the clinical outcomes were assessed at the end of 6 months. Conclusion: Correction of severe crowding may pose a significant challenge to the orthodontist. A combination of PAOO with PRF has shown beneficial therapeutic outcomes, better patient acceptance and enhanced soft tissue healing. It would be a viable alternative to the invasive orthognathic surgery.