PAOO-A PREDICTABLE INTER-DISCIPLINARY APPROACH IN ADULT ORTHODONTICS

A REPORT OF TWO CASES

Abstract

There has been a considerable surge in the percentage of adult patients seeking for orthodontic intervention over the last few decades. These adult patients are highly motivated, co-operative and compliant towards the treatment. At the same time, the expectations of the adult patients to get an effective and esthetic treatment in a shorter duration of time, present a challenge to the orthodontic professionals. The orthodontists, for a while are on a constant look out for modalities to fasten the tooth movement. However, with the interdiscipli­nary collaboration, the realm of orthodontics has considerably expanded the conventional orthodontic treatment protocols. To address the concerns of the overall orthodontic treatment time, a number of less invasive interim surgical techniques have been developed. These techniques have not only aided in accelerating orthodontic tooth movement but also have found high acceptance among the patients as well as the dental community. Periodontal accelerated osteogenic orthodontics (PAOO) is one such clinical procedure. It combines alveolar corticotomy & particulate bone grafting. The surgical procedure is followed by the application of orthodontic forces. Here we have two cases of Angle’s Class I malocclusion with bimaxillary protrusion managed with fixed orthodontic mechanotherapy and PAOO. This procedure is theoretically based on the regional acceleratory phenomenon (RAP), which is a bone healing pattern. The tooth movement was enhanced shortening the treatment time and increasing post treatment stability. The cases were completed with increased alveolar volume and intact periodontal housing. The desired degree of facial remodeling and facial esthetics was achieved.