It is well established that adjunctive surgical activation can increase the rapidity of orthodontic tooth movement and utilization of preorthodontic surgical intervention, as well as reduce rates of root resorption and the need for orthognathic surgery. Orthodontic tooth movement induces bone resorption at the compression side of the tooth and bone deposition at the tension side of the tooth, ultimately resulting in tooth movement in the direction of the compression.
Periodontally accelerated osteogenic orthodontics (PAOO) leverages regional acceleratory phenomenon (RAP) to allow for an increase in sustained, rapid tooth movement. Without tooth movement, the effects of RAP phenomenon generally begin within a few days of injury and typically peak at one to four months. This upregulation of tooth movement can be sustained with ongoing tooth movement from six to 24 months. After completion of orthodontic tooth movement, reestablishment of normal histologic structures and remineralization occur. This course will review the underlying principles of PAOO, ideal case selection, typical case outcomes with PAOO, and the steps and armamentarium for PAOO surgery.
Educational objectives
Upon completion of this course, the dental professional should be able to:
- Develop an understanding of the history and rationale for PAOO to accelerate orthodontic therapy.
- Assess the underlying biological mechanisms that allow for PAOO to improve orthodontic outcomes.
- Critically evaluate the indications and contraindications for PAOO as an adjunct to traditional orthodontic therapy.
- Establish an understanding of the surgical and orthodontic protocols for PAOO and potential innovations and treatment alterations.
About the Author
Mia L. Geisinger, DDS, MS, is a professor and director of advanced education in periodontology at the University of Alabama at Birmingham (UAB). Dr. Geisinger received her BS in biology from Duke University, her DDS from Columbia University School of Dental Medicine, and her MS and certificate in periodontology and implantology from the University of Texas Health Science Center at San Antonio. Dr. Geisinger is a diplomate in the American Board of Periodontology. She has served as the president of the American Academy of Periodontology Foundation (AAPF), as the chair of the American Dental Association’s Council on Scientific Affairs, and on multiple national and regional organized dentistry committees. She currently serves as the vice president of the AAP and on the Board of Directors for the ADA Science & Research Institute. She has authored over 60 peer-reviewed publications, and she lectures nationally and internationally on topics in periodontology and oral health care.
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