Periodontal accelerated osteogenic orthodontics: a description of the surgical technique (original) (raw)
Related papers
Periodontally Accelerated Osteogenic Orthodontics- The Past and the Future
2016
Wickodontics- also known as PERIODONTALLY ACCELERATED OSTEOGENIC ORTHODONTICS is a relatively new treatment in the orthodontic realm. It was introduced by Wilckobrothers. Periodontally Accelerated Osteogenic Orthodontics is a clinical procedure combining selective alveolar decortications particular bone grafting and application of orthodontic forces. This procedure is therotically based on the bone healing pattern known as the REGIONAL ACCELERATORY PHENOMENON (RAP). PAOO is a technique which brings about easy tooth movement in a short period of time. The purpose of this article is to describe the history, biology, clinical surgical procedure, indication, contraindication and possible complications of the PAOO procedure.
Cureus
The current review aimed to critically and systematically evaluate the available evidence regarding the effectiveness of periodontally accelerated osteogenic orthodontics (PAOO) in accelerating orthodontic tooth movement and supporting the alveolar bone. Additionally, this review aimed to analyze the untoward effects of this procedure and the patient-reported outcome measures. A comprehensive electronic search was performed on 10 databases in addition to a manual search to retrieve all relevant studies. Randomized controlled trials (RCTs) were only included in this review. The interventional group was the PAOO procedure, whereas the control group was either a non-accelerated traditional fixed orthodontic treatment or an accelerated treatment using any other intervention. The Cochrane risk of bias tool for randomized controlled trials (RoB 2) was employed to estimate the risk of bias in the included studies. The current review included eight RCTs evaluating 175 participants (63 males and 112 females) with a mean age ranging from 18.8 to 29.6 years. Five of them assessed the effectiveness of PAOO versus traditional orthodontic treatment, i.e. without any adjuvant surgical intervention. At the same time, the remaining three studies evaluated the effectiveness of PAOO versus corticotomy-only as an adjunctive procedure. The PAOO accelerated the leveling and alignment stage from 39% to 47% and accelerated the retraction of the upper anterior teeth from 41% to 61% compared to conventional orthodontic treatment. One study only indicated that PAOO reduced treatment time by 30.3% versus a corticotomy-only as an adjunctive procedure. No significant side effects have been reported with the PAOO procedure. The PAOO procedure was effective in accelerating orthodontic movement and tended to increase the thickness of the alveolar bone. But most periodontal outcome measures regarding PAOO application were not comprehensively covered in the included trials.
Periodontally Accelerated Osteogenic Orthodontics : A Mini Review
International Journal of Scientific Research in Science and Technology, 2020
With an increasing number of patients seeking orthodontic treatment, it often poses a challenge to the attending orthodontist to seek modalities that may promote accelerated tooth movement without compromising the underlying tissues and periodontium. Hence, PAOO (Periodontal accelerated osteogenic orthodontics was introduced in order to overcome current conventional treatment limitations. It seeks to combine selective bone corticotomy, hard tissue grafting along with the application of orthodontic forces, therefore promoting an increase in the width of the alveolar bone, lesser root resorption and lesser chair side appointments. This procedure aims at accelerating tooth movement and providing long-term improvement of the periodontium, decreased need for extractions, thereby augmenting gingival esthetics. The aim of this review was to summarize current literature regarding the role of PAOO in orthodontics.
Periodontally assisted osteogenic orthodontics: A review
The periodontally accelerated osteogenic orthodontic (PAOO) technique combines selective decortication facilitated orthodontics with periodontal regeneration in order to create rapid orthodontic tooth movement (OTM). This reduces potential side effects like root resorption, tooth devitalization, relapse, inadequate basal bone and bacterial time load factors like caries and periodontal infection. Tooth movement can be achieved with increased alveolar volume providing for a more intact periodontium, decreased need for extractions, degree of facial remodelling and increased bone support for teeth and overlying soft tissues, thus, augmenting gingival and facial esthetics. With an increasing number of adults considering orthodontic treatment, with a propensity for periodontal problems, PAOO technique can be a powerful and attractive treatment option in dental treatment.
Periodontally Accelerated Osteogenic Orthodontics: A Review of the Literature
Synergism between periodontists and orthodontists creates crucial opportunities to enhance clinical outcomes of combined therapies regarding both disciplines. Collaboration of these specialities leads to promoted periodontal health as a result of orthodontic treatment or intensified orthodontic therapy due to proper periodontal maintenance, reciprocally. Co-operative approaches of periodontology and orthodontics play significant role not only in conventional therapies but also in emerging treatment alternatives such as periodontal accelerated osteogenic orthodontics™ (PAOO). PAOO™ technique is defined as the orthodontic treatment combined with alveolar corticotomy plus bone augmentation grafting. As a promising adjuvant technique based on the transient nature of demineralization-remineralisation process in healthy tissues, PAOO™ consists of alveolar corticotomy and bone grafting of labial and palatal/lingual surfaces, followed by orthodontic force. Main benefits of PAOO™ are listed as reduced orthodontic treatment time, increased bone volume and post-orthodontic stability. Although the historical background of corticotomy-assisted orthodontics lies back to 1800s, modern literature offers a few animal studies and human clinical cases, where controlled prospective and histologic studies are needed to confirm the long-term success of this technique. On this basis, our review aimed to revise the perspective of PAOO™ technique through historical background, biologic basis and clinical considerations.
Periodontally accelerated osteogenic orthodontics: A perio-ortho ambidextrous perspective
Journal of Family Medicine and Primary Care, 2020
The interdisciplinary collaboration of periodontics and orthodontics has allowed teeth to be moved 2–3 times faster, reducing the time required for traditional orthodontic therapy considerably. Periodontally accelerated osteogenic orthodontics (PAOO), also known as Wilckodontics, is a combination of a selective decortication facilitated orthodontics and alveolar augmentation. With this technique, there is no dependence on the pre-existing alveolar volume. This case report describes the treatment of permanent mandibular molar protraction in a 14-year-old patient undergoing orthodontic therapy using PAOO with piezosurgery.
Periodontally accelerated osteogenic orthodontics: A case report
Indian Journal of Public Health Research and Development, 2016
This case report depicts corticotomy-assisted rapid orthodontic procedure known as periodontally accelerated osteogenic orthodontics (PAOO) without the use of bone grafts. A 28-year-old man, with class I malocclusion, congenitally missing upper laterals and severe spacing of maxillary anterior teeth, was treated with the PAOO procedure. Labial and palatal mucoperiosteal flaps were reflected, and selected vertical corticotomy cuts upto 0.5mm in depth interdentally and horizontal cuts was performed around the roots in the maxillary arches. Orthodontic tooth movement was started immediately and adjusted every 3 weeks. Six months after corticotomy surgery, active orthodontic treatment was completed. No root resorption or detrimental periodontal effects were seen. The alveolar ridges of the maxilla maintained its original thickness. It was thus concluded that PAOO is an excellent treatment approach in adults to accelerate the rate of tooth movement and shorten treatment time. This technique has recently gained popularity as an alternative treatment option for adults in whom the jaws are fully mature. Case selection is very important in PAOO and the orthodontist, oral surgeon and periodontist should team up for achieving excellent results. More clinical studies with increased number of patients and long-term follow-up are needed to determine the effectiveness and stability of the results of these cases.
Curēus, 2024
To evaluate the relative efficacy of periodontally accelerated osteogenic orthodontics (PAOO) compared to conventional fixed appliances in correcting lower anterior teeth crowding using a non-extraction treatment approach. Material and methods A single-center, two-arm, parallel-group randomized controlled trial was conducted on 38 patients (9 males, 29 females) with moderate crowding. These patients did not require premolar extraction and were randomly allocated into two treatment groups: the PAOO group and the conventional orthodontic treatment group. The Little Irregularity Index (LII) measured crowding intensity on pre-treatment study models. Changes in this index were recorded monthly in both treatment groups. The inter-canine width, inter-second-premolar width, plaque index (PI), gingival index (GI), and papillary bleeding index (PBI) were also measured before and after the leveling and alignment stage. Statistical analysis between the two groups was performed using Mann-Whitney U tests. Results For the LII, the average time for irregularity resolution was three months in the PAOO group, compared to five months in the conventional orthodontic treatment group. Regarding changes in inter-second-premolar width, the PAOO procedure led to a significant decrease in the increase of inter-second-premolar width, with an average increase of +1.52 mm compared to +2.71 mm in the control group. For the GI and PBI, it was found that their values significantly increased with PAOO application, averaging 0.18 and 0.17, respectively, compared to 0.05 and 0.07 in the control group. Conclusions The use of PAOO in orthodontic treatment accelerated the leveling and alignment process by 40%. Changes in the inter-canine width, the inter-second-premolar width, and the status of periodontal tissues were minimal and clinically negligible.