Effect of Periodontally Accelerated Osteogenic Orthodontics (PAOO) on Periodontium: A case report

Background: Periodontally accelerated osteogenic orthodontics found to be effective in accelerating orthodontic treatment. Proper case selection and careful surgical and orthodontic treatment is very important. This technique accelerates the tooth movement while maintaining the integrity of the periodontium. The aim of this paper is to present rapid and effective Periodontally accelerated osteogenic orthodontics treatment while maintaining the integrity of periodontium. Methods: Subject diagnosed with angle class II,div.I malocclusion with healthy periodontium was included. After initial orthodontic alignment and leveling Periodontally accelerated osteogenic orthodontics advocated for comprehensive fixed orthodontic appliances in conjunction with full thickness flaps with labial and lingual corticotomies around teeth to be moved in was performed. Bone graft (DFDBA) was applied directly over the bone cuts and flaps sutured .Periodontal variables including Pocket Probing Depth ,Plaque Index,Gingival Index and Clinical Attachment Level were taken at baseline and after 1,3 and 6 months Tooth movement was initiated two weeks after the surgery, with activation of orthodontic appliance every 2 weeks. Results: All the periodontal variables after completion of the treatment were almost similar to the baseline values showing no attachment loss or increased pocket depth. Orthodontic treatment time with this technique reduced to nearly one-third the time of conventional orthodontics. Conclusion: Alveolar augmentation were used in an effort to enhance and strengthen the periodontium, reasoning that the addition of bone to alveolar housing ,ensures root coverage as the dental arch expanded. Controlled clinical and histological studies are needed to understand the biology of tooth movement, the effect on teeth and bone, post-retention stability,and determining the status of the periodontium and roots after treatment.