Periodontally Accelerated Osteogenic Orthodontics (PAOO)- A Case Report

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 teamup 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.