[Downloaded free from http://www.jpbsonline.org on Thursday, December 22, 2022, IP: 242.148.66.

201]

Review Article

Periodontal Accelerated Osteogenic Orthodontics Technique for Rapid

Orthodontic Tooth Movement: A Systematic Review
Venkataramana Vannala, Anilkumar Katta1, Manchala S. Reddy2, Shishir R. Shetty3, Raghavendra M. Shetty4,
Shakeel S. Khazi5

Department of Aim: The aim of this review was to analyze the data in the available literature

Abstract
Orthodontics, College of
regarding aspects of periodontally accelerated orthodontic therapy such as
Dentistry, Gulf Medical
University, Ajman,
reduction in treatment time, variation in surgical techniques, and patient
United Arab Emirates, satisfaction. Materials and Methods: An internet-based search was performed
1
Consultant Orthodontist, for the articles published between January 2008 and August 2018 using keywords
Smile 4 All Dental Clinic, periodontal accelerated orthodontic tooth movement, corticotomy, bone
Guntur, Andhra Pradesh, grafting, tooth movement, and treatment duration. A  total of 84 articles were
India, Departments obtained from MEDLINE and Embase search engines, of which 31 articles
of 2Periodontics, 3Oral were eligible to be included for the systematic review. Results: On analysis, it was
Medicine and Radiology,
4
Pediatric Dentistry,
observed that the earlier studies were predominantly pertaining to case reports.
5
Prosthodontics, College In the later part of the decade considered in this review, it was observed that
of Dentistry, Gulf Medical the emphasis was given to clinical and animal studies. Conclusions: Most of the
University, Ajman, United studies included in the review concluded that there was a significant reduction
Arab Emirates in orthodontic treatment duration using periodontal accelerated techniques
compared to conventional orthodontic treatment.
Keywords: Bone grafting, corticotomy, periodontal accelerated orthodontic tooth
movement (PAOO), tooth movement, treatment duration

Introduction patients seeking ortho treatment in order to improve

T    o achieve the orthodontic objectives of a functional
   and esthetic dentition, which most patients and
clinicians desire for, orthodontic treatment must be
performed. Orthodontic tooth movement can be
brought by use of either fixed or removable appliances
by applying different forces. Force when applied on to
a tooth in a particular direction results in physiological
tooth movement. Factors that play an important role
in tooth movement are quality and quantity of force
and treatment time. Along with this, knowledge about
growth and development of dentofacial complex
is essential. In today’s time, dental appearance is
considered as an important feature while defining the
facial appeal as it plays an important role in human
social interactions.[1-4] Recent reports have stated that
there is a relationship between dental malocclusion,
psychosocial well-being, and self-esteem.[5] In
addition, current trend is that we have more of adult
Access this article online
Quick Response Code:
Website: www.jpbsonline.org
their facial appearance.[6-9] It is estimated that the
approximately 12–24  months is the time needed for
comprehensive orthodontic treatment, which in turn
depends upon severity, treatment plan, and individual
characteristics. Prolonged treatment time means this
can be an added risk factor for other dental problems
such as root resorption, caries, and periodontal disease
due to poor oral hygiene.[10-12]
To reduce orthodontic treatment time due to
patient demand, orthodontists have tried to
accelerate tooth movement using various methods
such as photobiomodulation,[13] pharmacological
Address for correspondence: Dr. Venkataramana Vannala,
Department of Orthodontics,
College of Dentistry, Gulf Medical University,
Ajman 4184, United Arab Emirates.
E-mail: dr.venkataramana1974@gmail.com
This is an open access journal, and articles are distributed under the terms of the
Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows
others to remix, tweak, and build upon the work non-commercially, as long as
­appropriate credit is given and the new creations are licensed under the identical terms.
For reprints contact: reprints@medknow.com

How to cite this article: Vannala V, Katta A, Reddy MS, Shetty SR,
Shetty RM, Khazi SS. Periodontal accelerated osteogenic orthodontics
DOI: 10.4103/jpbs.JPBS_298_18
technique for rapid orthodontic tooth movement: A systematic review.
J Pharm Bioall Sci 2019;11:S97-106.

© 2019 Journal of Pharmacy and Bioallied Sciences  |  Published by Wolters Kluwer - Medknow S97
[Downloaded free from http://www.jpbsonline.org on Thursday, December 22, 2022, IP: 242.148.66.201]
Vannala, et al.: Rapid tooth movement by PAOO
approaches,[14] and low-intensity laser irradiation.[15]
Among all these procedures, surgical procedure, i.e.,
periodontally accelerated osteogenic orthodontics
technique (PAOO), has widely been popularized[16] as
it significantly reduced orthodontic treatment time.[17,18]
What is periodontally accelerated osteogenic
orthodontics?
It is a combination of periodontal and orthodontic
treatment, which included surgical alveolar decortication
followed by bone grafting and orthodontic treatment.
The end results of this procedure lead to long-term
improvement of the periodontium with reduction in
orthodontic treatment time.[19] Name it decortication
or corticotomy in simple terms, it means intentional
cutting or injury of cortical bone.
Regional accelerating phenomenon (RAP) is the main
biological mechanism behind the acceleration of
orthodontic tooth movement, which was proven by
most of the animal studies. RAP has been defined as
a re-organization activity and physiologic event that
happened next to the site of injury, resulting in regional
reduction in bone density in the healthy tissue.[20]
The rationale behind this particular method comprises
careful alveolar decortication, which is a form of
periodontal tissue engineering causing transient
osteopenia and high turnover adjacent to the injury
site. Alveolar decortication initiates a healing response,
the amount of which is directly related to the intensity
and proximity of the surgical insult.
Historic view: L. C. Bryan (1892) was the first to treat
malocclusion cases with the help of corticotomy
procedure; later Heinrich Kole[11] reintroduced this
procedure to correct malocclusion. Of late, Wilcko
et  al.[17] termed selective alveolar decortication
combined with grafting and orthodontic treatment.
They coined the term PAOO. Authors reported that
6–8 months were the time required to treat orthodontic
cases with the help of PAOO surgery, which was quite
faster than the conventional orthodontic treatment.[20]
Indications
• It enhances alveolar bone volume and periodontium
(i.e., correction of dehiscences and fenestrations).
• Reduces treatment time (i.e., 3–4 times more rapid
active orthodontic treatment).
• Better posttreatment stability and a lesser amount
of relapse.
• Malocclusion treatment scope can be enhanced of
(i.e., avoiding orthognathic surgery and extractions
in selected cases).
• Patient’s profile can be improved if needed.
• Rapid recovery of impacted teeth (i.e., canines).
S98 Journal of Pharmacy and Bioallied Sciences  ¦  Volume 11  ¦  Supplement 2  ¦  May 2019
Contraindications
• Thinner mandibular cortices
• Patients with active periodontal disease or gingival
recession
• Palatal expansion
• In the treatment of severe posterior cross-bite
• Bimaxillary protrusion when accompanied with a
gummy smile
Search strategy
This systematic review was conducted in the College
of Dentistry, Gulf Medical University, Ajman, United
Arab Emirates, between January 2008 and August
2018. A  literature survey was conducted to identify
all aspects of the studies that examined the effect,
indications, and the biology of corticotomy. MEDLINE
in process and other nonindexed citation, PubMed,
and Embase reviews were searched. Keywords used
included Periodontally Accelerated Orthodontic Tooth
movement (PAOO), Corticotomy, Bone grafting, tooth
movement, and treatment duration. Articles in the form
of case reports, case series, and research studies were
included in the review. Review articles were excluded.
Only English language full-text articles were used as
data source.
Eligibility criteria
Randomized controlled trials (RCTs), prospective
controlled studies, and retrospective controlled
trials were considered eligible to be included in the
systematic review. The studies had to be in English
language only, addressing at least some aspect of
PAOO in both human and animals. Eligibility of
potential studies was determined by reading the title
and abstract of each article identified by the search,
and then full texts of the articles were retrieved
from the selected abstracts/titles. Two reviewers were
assigned to review the full text of articles and were
calibrated to use the review process adopted in this
review. The data were categorized and tabulated into
clinical studies [Table 1] and animal studies [Table 2].
Conclusions
Due to the swift outcome of the treatment, adults
shifting toward orthodontic treatment are more
in number and forgo their taboos concerning the
duration of treatment. PAOO is a technique that
has many applications in the orthodontic treatment
for adults because it helps to overcome many of
the current limitations of conventional treatment,
including lengthy duration, potential for periodontal
complications, lack of growth, and the limited
envelope of tooth movement. Further, randomized
 Table 1: Clinical Studies
S.No Authors Study design Case selection Type of study Study duration Surgical procedure Patient Conclusion
satisfaction
1 Thind et al.[21] Case control Group I: 20 Orthodontic extraction Group I was Study compared Not mentioned Authors reported significant
study patients space closure 5 months and 2 the effectiveness of reduction in PAOO treatment
underwent weeks and for Group corticotomy with duration with surgical bur
PAOO treatment II was 7 months and surgical bur and on compared with PAOO
with surgical 1 week piezocision piezosurgery in conventional
bur Group orthodontic treatment
II: 20 patients
underwent PAOO
with piezocision
2 Brugnami Retrospective Group I 79 Decrowding and the Treatment time of Corticotomy- Not mentioned Authors concluded that
et al.[22] analysis patients patient sample included 9 months facilitated orthodontic corticotomy along with
corticotomy both Angle Class I and therapy with and simultaneous bone grafting
with bone graft Class II malocclusion without bone graft appears to be an effective
and Group II patients technique to diminish the risk
surgically assisted of marginal bone resorption
orthodontics and fenestration when a tooth
(corticotomy) is orthodontically inclined or
without bone moved toward, or even outside
grafting the cortical plane. In contrary
corticotomy by itself, without
concomitant bone grafting
does not produce similar
results
3 Addanki Split-mouth 16 patients were Angle’s Class I and Treatment time of Buccal and palatal Not mentioned Authors reported that there
et al.[23] study divided into 2 Class II cases with first 6 months corticotomy was no significant difference in
designed groups of 8 each premolar extraction compared with buccal the duration of tooth between
Vannala, et al.: Rapid tooth movement by PAOO

corticotomy alone right and left arches with

[Downloaded free from http://www.jpbsonline.org on Thursday, December 22, 2022, IP: 242.148.66.201]

respect to bone density

4 Mahantesha Case report Two patients Angle’s Class 1 Time duration Corticotomy was Not mentioned PAOO method in combination
et al.[24] malocclusion with for first case was performed followed with selective decortications
maxillary protrusion of 4 months and second by placement of bone facilitated orthodontic
jaws was for 5 months graft assisted with technique and alveolar
orthodontic treatment augmentation
5 Bahammam[25] Single- 33 orthodontic Treatment of adult Duration of Study compared Not mentioned PAOO decreases the duration
masked patients (20 patients with moderate orthodontic the effectiveness of of active treatment and reduces
clinical trial women, 13 crowding of the teeth treatment was a bovine-derived the risk of root resorption in
men; mean age markedly reduced for xenograft with that of adult patients. Use of a bovine-
21.2 ± 1.43 (18– 27) about 14 weeks in all bioactive glass when derived xenograft with

Journal of Pharmacy and Bioallied Sciences  ¦  Volume 11  ¦  Supplement 2  ¦  May 2019
groups combined with PAOO modified corticotomy provided
superior benefits in terms of
increased bone density than

S99
did the use of bioactive glass
 Table 1: Continued

S100
S.No Authors Study design Case selection Type of study Study duration Surgical procedure Patient Conclusion
satisfaction
6 Awasthi Case report One patient Anterior open bite and The total treatment Orthodontic treatment Not mentioned The modified decortication
et al.[26] flared and spaced upper time was 41/2 with combined with technique reduced the treatment
and lower incisors active period of the modification time to a considerable extent.
2 months in conventional The interdental spacing closed
wilckodontics and optimum overjet and
technique overbite was achieved
7 Charavet RCT 24 adult patients Adult patients The overall treatment Piezocision, which Patient The piezocision technique
et al.[27] presenting with mild time was 7 months is a minimally satisfaction seemed to be effective in
overcrowdings invasive approach to was accelerating orthodontic
corticotomy has been significantly tooth movement. No gingival
used in this study better in the recessions were observed.
piezocision The risk of residual scars
group than might limit the indications for
in the control piezocision in patients with a
group high smile line
8 Ahn et al.[28] Case and 30 adult patients 30 Class III adult Treatment time was Augmented Not mentioned Augmented corticotomy
control study patients 10.9 months in the corticotomy labial to provided a favorable
control group and the anterior mandibular decompensation pattern of the
8.7 months in the roots: experimental mandibular incisors, preserving
experimental group group (with augmented the periodontal structures
corticotomy, n = 15) surrounding the mandibular
and control group anterior teeth for skeletal
(without augmented Class III patients
corticotomy, n = 15)
9 Jahanbakhshi Split-mouth 15 adult female Therapeutic need for Canine retraction Buccal corticotomy in Not mentioned Corticotomy can accelerates
et al.[29] design patients extraction of maxillary was significantly accelerating maxillary the rate of orthodontic tooth
Vannala, et al.: Rapid tooth movement by PAOO

first premolars and higher on the canine retraction movement about two times
[Downloaded free from http://www.jpbsonline.org on Thursday, December 22, 2022, IP: 242.148.66.201]

maximum canine corticotomy side faster than conventional

Journal of Pharmacy and Bioallied Sciences  ¦  Volume 11  ¦  Supplement 2  ¦  May 2019
retraction than the control side orthodontics and it is
by an average of significant in early stages after
1.8 mm/month surgical procedure
10 Munoz A pilot Cohort of 11 Patients in need of The average PAOO technique with Mild or L-PRF is simple and safe to
et al.[30] prospective patients orthodontic treatment orthodontic leukocyte and platelet- moderate use in PAOO. Combination
observational treatment time was rich fibrin (L-PRF) with traditional bone grafts
study 9.3 months. (incorporated into the potentially accelerates
graft and as covering wound healing and
membrane) was reduces postsurgical pain,
performed inflammation, infection
without interfering with tooth
movement, and/
or postorthodontic stability,
over a 2-year period
 Table 1: Continued
S.No Authors Study design Case selection Type of study Study duration Surgical procedure Patient Conclusion
satisfaction
11 Abbas et al.[31] Case and 20 patients (15– Class II Division 1 Treatment time was Corticotomy- Not mentioned CFO and piezocision are
control study 25 years old) malocclusions for 12 weeks facilitated orthodontics efficient treatment modalities
(CFO) and piezocision for accelerating canine
in rapid canine retraction
retraction
12 Wu et al.[32] Pilot study Three young Skeletal Class III The average total After aligning and Not mentioned The facial aesthetics of three
adult patients surgical cases treatment time was leveling the dental patients improved following
20.4 ± 2.4 months arches, a piezosurgical multidisciplinary treatment.
corticotomy was This approach may be an
performed to the buccal efficient method for the
aspect of the alveolar orthognathic patient who
bone desires a reduced treatment
time, but further clinical
research is required
13 Sakthi et al.[33] Case and 40 adult patients Bimaxillary protrusion Average treatment Corticotomy-assisted Not mentioned The rate of retraction with
Control study requiring correction of time was 4 months en masse orthodontic study group was twice as faster
bidental proclination retraction when compared to the control
group, accelerating during the
first 2 months of retraction.
There was better anchorage
control with the undecorticated
molar segment during the
retraction period but was found
to increase as time advanced.
14 Bhattacharya RCT Twenty patients Orthodontic treatment The mean time for the Corticotomy-assisted Not mentioned Alveolar corticotomies
et al.[34] (age>15 y) with upper anterior en masse retraction orthodontic tooth not only accelerates the
Vannala, et al.: Rapid tooth movement by PAOO

retraction in the in the corticotomy movement orthodontic treatment but,

[Downloaded free from http://www.jpbsonline.org on Thursday, December 22, 2022, IP: 242.148.66.201]

extraction space of first group was found to also provides the advantage
premolar was selected be 131 ± 7.5 days, of increased alveolar width to
in comparison to support the teeth and overlying
234 ± 9 days for structures
the conventional
technique
15 Al-Naoum Split-mouth 30 patients (15 Orthodontic treatment Space closure was Corticotomy to 50% and 30% Alveolar corticotomy increased
et al.[35] design RCT males and 15 required canine significantly faster on facilitate tooth of patients orthodontic tooth movement
females) retraction was included the experimental side movement reporting and was accompanied by
than on the control severe pain at moderate degrees of pain and
side (mean = 0.74 mm/ 1 and 3 days discomfort

Journal of Pharmacy and Bioallied Sciences  ¦  Volume 11  ¦  Supplement 2  ¦  May 2019
week vs. 0.20 mm/ postoperatively
week between 1 week
after and immediately

S101
after surgery
 Table 1: Continued

S102
S.No Authors Study design Case selection Type of study Study duration Surgical procedure Patient Conclusion
satisfaction
16 Krishnan Patients between Retraction of anterior Average retraction Osteotomy with Not mentioned This method of achieving
et al.[36] the age of 18 and teeth time both maxillary undermining of faster en masse retraction
25 years and mandibular interseptal bone at immediately after extraction
arches was of 9 the extraction site was definitely reduced the initial
weeks performed retraction time. We recommend
that such procedure must be
carried out with appropriate
anchorage conservation
methods
17 Coscia et al.[37] Fourteen patients Patients with surgical On average Augmented Not mentioned This approach decreases the
(8 men, 6 women; skeletal Class III orthodontic corticotomy plus risk of the typical periodontal
mean age, treatment accelerated orthodontic complications associated with
26.14 year) duration was of treatment traditional orthodontics, such
8.23 ± 2.67 months as marginal bone loss and
gingival recession
18 Yezdani [38] Case report 29-year-old Class I malocclusion Orthodontic Selective alveolar Good The rapid orthodontic tooth
woman and increased by treatment time was decortication in movement was attributed
dentoalveolar for 7 months conjunction with to the regional acceleratory
protrusion with periodontal alveolar phenomenon, triggered by
increased spacing augmentation with a selective alveolar decortication.
between the maxillary bone graft and rapid The subsequent periodontal
and mandibular orthodontic tooth alveolar augmentation with the
incisors movement bone graft repaired the bony
dehiscences and enhanced the
bone volume and dramatically
improved the patient’s soft
Vannala, et al.: Rapid tooth movement by PAOO

tissue profile
[Downloaded free from http://www.jpbsonline.org on Thursday, December 22, 2022, IP: 242.148.66.201]

19 Shoreibah RCT 20 patients Moderate crowding of Treatment duration CFO Not mentioned CFO tooth movement using

Journal of Pharmacy and Bioallied Sciences  ¦  Volume 11  ¦  Supplement 2  ¦  May 2019
et al.[39] the lower anterior teeth 14–20 weeks a further modified technique
significantly reduces the total
time of treatment
20 Choo et al.[40] 24 adults With maxillary or The average total Maxillary Not mentioned Speedy surgical orthodontic
bimaxillary protrusion treatment time was perisegmental treatment can be an effective
20 months (range, corticotomy followed modality for adults with severe
11–42 months). by the orthopedic maxillary protrusion
en masse retraction
against C-palatal
miniplate anchorage
 Table 1: Continued
S.No Authors Study design Case selection Type of study Study duration Surgical procedure Patient Conclusion
satisfaction
21 Wilcko and Case report Two patients Crowding and space Treatment duration Orthodontics is Not mentioned The accelerated osteogenic
Wilko[1] closing was 6 -7 months for combined with orthodontics technique
two patients. full-thickness flap provides for efficient and stable
reflection, selective orthodontic tooth movement
alveolar decortication,
ostectomy, and bone
grafting
22 Nowzari Case report 41-year-old man With class II, division 2 Treatment time was Use of particulate Not mentioned PAOO is an effective treatment
et al.[41] crowded occlusion 8 months autogenous bone graft approach in adults to decrease
with the corticotomy- treatment time and reduce the
assisted rapid risk of root resorption
orthodontic procedure
was carried out
23 Lee et al.[42] Cohort study 65 Korean adult Bimaxillary Treatment duration Anterior segmental Not mentioned Orthodontic treatment or
female patients dentoalveolar ranged between 14 osteotomy, and corticotomy-
protrusion conditions and 27 months corticotomy-assisted assisted orthodontic treatment
orthodontic treatment is indicated for those with
for resolution severe incisor proclination
of bimaxillary with normal basal bone
dentoalveolar position. Anterior segmental
protrusion osteotomy is recommended
for bimaxillary dentoalveolar
protrusion patients with a
gummy smile, basal bone
prognathism, relatively normal
incisor inclination, and
Vannala, et al.: Rapid tooth movement by PAOO

relatively underdeveloped chin

[Downloaded free from http://www.jpbsonline.org on Thursday, December 22, 2022, IP: 242.148.66.201]

position

Journal of Pharmacy and Bioallied Sciences  ¦  Volume 11  ¦  Supplement 2  ¦  May 2019
S103
 Table 2: Animal studies

S104
S. No Authors Animals used for Type of study Methodology Conclusion
the study
1 Chen et al.[43] 40 rabbits Split-mouth, randomized Left mandible was subjected to decortication- Following alveolar decortication, osteoclastogenesis
controlled experimental facilitated orthodontics, and right mandible was initially induced to a greater degree than the new
design underwent traditional orthodontics as a bone formation, which was thought to have caused
control. a RAP. The amount of osteoclastogenesis in the
The animals were killed on the days 1, 3, decorticated alveolar bone was found to have two
5, 7, and 14, after undergoing orthodontic peaks, perhaps due to attenuated local resistance
procedures
2 Lee et al.[44] Six male beagle Split-mouth, randomized Decortication was performed on the buccal All groups had considerable new bone formation
dogs controlled experimental bone surface of six male beagle dogs that on the pressure side. New bone formation on the
design were randomly assigned to receive grafts of buccal side and buccal plate formation in the coronal
deproteinized bovine bone mineral, irradiated direction along the root surfaces were induced by the
cortical bone, or synthetic bone. Immediate bone-derived and PDL-derived mesenchymal matrix,
orthodontic force was applied to the second respectively. The angular change between groups
and third premolars for buccal tipping for 6 was significantly different (P < 0.001). Augmented
weeks corticotomy using non-autogenous graft materials
facilitated tooth movement without fenestrations and
accelerated new bone formation on the pressure side
3 Ahn et al.[45] 20 beagles dogs RCT Surgical procedure: alveolar osteotomy A bone graft into the surgical defect can not only
alone (control) or osteotomy with bone graft allow immediate force application for accelerating
(experimental group) orthodontic tooth movement with favorable
periodontal regeneration, but also decrease the risk
of inhibited orthodontic tooth movement in case of
delayed force application after surgery.
4 Yuan et al.[46] 30 male adult Case and control study Le Fort I osteotomies were performed on the Le Fort I osteotomy significantly accelerated the rate
Sprague-Dawley left maxillas of one group. After surgery, a of orthodontic tooth movement. Histologically, more
rats continuous force of 0.5 N was placed on the active and extensive bone remodeling was observed
Vannala, et al.: Rapid tooth movement by PAOO

maxillary left first molar to move the tooth after osteotomy

[Downloaded free from http://www.jpbsonline.org on Thursday, December 22, 2022, IP: 242.148.66.201]

mesially. Other group served as controls were

Journal of Pharmacy and Bioallied Sciences  ¦  Volume 11  ¦  Supplement 2  ¦  May 2019
5 Kim et al.[47] Ten beagle dogs Case and control study
were divided into
two groups.
only orthodontic force was applies
Traditional orthodontic tooth movement
was performed in the control group. In the
experimental group, a piezotome was used to
make cortical punctures penetrating the gingiva
around the moving tooth
The cumulative tooth movement distance was greater
in the piezopuncture group than in the control
group: 3.26-fold in the maxilla and 2.45-fold in the
mandible. Piezopuncture significantly accelerated
the tooth movements at all observation times, and
the acceleration was greatest during the first 2
weeks for the maxilla and the second week for the
mandible. Anabolic activity was also increased by
piezopuncture: 2.55-fold in the maxilla and 2.35-fold
in the mandible
[Downloaded free from http://www.jpbsonline.org on Thursday, December 22, 2022, IP: 242.148.66.201]

Vannala, et al.: Rapid tooth movement by PAOO

testing in humans is still necessary to confirm

under tension; this was replaced by fibrous tissue after

this mechanism underlies the rapid orthodontic tooth
formation during the earlier stages of treatment, and

turnover of alveolar spongiosa, and the activity was

the claimed advantages of this technique and to

localized; dramatic escalation of demineralization–

Selective alveolar decortication induced increased
transient bone resorption around the dental roots
coupled mechanism of bone resorption and bone
evaluate the long-term effects of it. Interdisciplinary

Corticotomy-assisted tooth movement produced

enhances the rate of tooth movement during the
initial tooth displacement phase; this results in a
The data suggest that the alveolar decortication

remineralization dynamics is the likely biologic

mechanism underlying rapid tooth movement
communication and proper coordination are essential
for apt treatment planning and satisfying outcome.

following selective alveolar decortication

Financial support and sponsorship

21 days and by bone after 60 days

Nil.
Conclusion

Conflicts of interest
There are no conflicts of interest.

References
1. Wilcko TM, Wilcko WM. Accelerated osteogenic orthodontics
technique A-1 stage surgically facilitated rapid orthodontic
movement

technique with alveolar augmentation. J Oral Maxillofac Surg

2009;67:2149-59.
2. Lee W, Karapetyan G, Moats R, Yamashita DD, Moon HB,
Ferguson DJ, et  al. Corticotomy-/osteotomy-assisted tooth
movement microcts differ. J Dent Res 2008;87:861-7.
were injured in 36 healthy adult rats adjacent
palatal aspects of the left maxillary first molar
Surgery was performed around the buccal and

each side. Tooth movement was performed on

tooth and included five decortication dots on

Maxillary buccal and lingual cortical plates

3. Nowzari H, Yorita FK, Chang H-C. Periodontally accelerated

the first molar using a 25-g Sentalloy spring

to the upper left first molars. Twenty-four

osteogenic orthodontics combined with autogenous bone

animals were killed at 3, 7, or 11 weeks.

grafting. Compendium 2008:29:200-6.

4. Sebaoun JD, Kantarci A, Turner JW, Carvalho RS, Van Dyke
TE, Ferguson DJ. Modeling of trabecular bone and lamina dura
following selective alveolar decortication in rats. J Periodontol
Methodology

2008;79:1679-88.
Table 2: Continued

5. Wang L, Lee W, Lei DL, Liu YP, Yamashita DD, Yen SL.
Tissue responses in corticotomy- and osteotomy-assisted
tooth movements in rats:  Histology and immunostaining.
Am J Orthod Dentofacial Orthop 2009;136:770.e1-11;
discussion 770-1.
Corticotomy

6. Seifi M, Younessian F, Ameli N. The innovated laser assisted

flapless corticotomy to enhance orthodontic tooth movement. J
Lasers Med Sci 2012;3:20-5.
7. Hernández-Alfaro F, Guijarro-Martínez R. Endoscopically
assisted tunnel approach for minimally invasive corticotomies.
J Periodont 2012;83:574-80.
Sebaoun et al.[4] 36 healthy adult Case and control study

8. Owen AH. Accelerated invisalign treatment. JCO 2001;35:

Type of study

381-5.
9. Hassan AH, Fraidi AA. Corticotomy assisted orthodontic
treatment. Open Dent J 2010;4:159-64.
10. Thomas MB. An evidence-based analysis of periodontally
accelerated orthodontic and osteogenic techniques. Sem
Orthodont 2008;14:305-16.
RCT

RCT

11. Kole H. Surgical operations on the alveolar ridge to correct

occlusal abnormalities. Oral Surg Oral Med Oral Pathol
Animals used for

1959;12:515-29 concl.
divided into 5
the study
Baloul et al.[48] 114 Sprague-

12. Düker J. Experimental animal research into segmental alveolar

36 rats were
Dawley rats

movement after corticotomy. J Maxillofac Surg 1975;3:81-4.

13. Kau CH, Kantarci A, Shaughnessy T, Vachiramon A,
groups

Santiwong P, de la Fuente A, et  al. Photobiomodulation

rats

accelerates orthodontic alignment in the early phase of

treatment. Prog Orthod 2013;14:30.
14. McGorray SP, Dolce C, Kramer S, Stewart D, Wheeler TT. A
Wang et al.[5]
Authors

randomized, placebo-controlled clinical trial on the effects of

recombinant human relaxin on tooth movement and short-term
stability. Am J Orthod Dentofacial Orthop 2012;141:196-203.
15. Cruz DR, Kohara EK, Ribeiro MS, Wetter NU. Effects of
low-intensity laser therapy on the orthodontic movement
S. No

velocity of human teeth: A preliminary study. Lasers Surg Med

2004;35:117-20.
6

Journal of Pharmacy and Bioallied Sciences  ¦  Volume 11  ¦  Supplement 2  ¦  May 2019 S105
[Downloaded free from http://www.jpbsonline.org on Thursday, December 22, 2022, IP: 242.148.66.201]
Vannala, et al.: Rapid tooth movement by PAOO
16. Nimeri G, Kau CH, Abou-Kheir NS, Corona R. Acceleration
of tooth movement during orthodontic treatment—a frontier
in orthodontics. Prog Orthod 2013;14:42.
17. Wilcko WM, Wilcko T, Bouquot JE, Ferguson DJ. Rapid
orthodontics with alveolar reshaping:  Two case reports of
decrowding. Int J Periodontics Restorative Dent 2001;21:9-19.
18. Wilcko MT, Wilcko WM, Bissada NF. An evidence-based
analysis of periodontally accelerated orthodontic and
osteogenic techniques:  A synthesis of scientific perspectives.
Semin Orthod 2008;14:305-16.
19. Wilcko WM, Ferguson DJ, Bouquot JE, Wilcko MT. Rapid
orthodontic decrowding with alveolar augmentation:  case
report. World J Orthod 2003;4:197-205.
20. Hassan AH, Al-Saeed SH, Al-Maghlouth BA, Bahammam
MA, Linjawi AI, El-Bialy TH. Corticotomy-assisted
orthodontic treatment. A  systematic review of the biological
basis and clinical effectiveness. Saudi Med J 2015;36:794-801.
21. Thind SK, Chatterjee A, Arshad F, Sandhu PS, Thind MS,
Nahin J. A clinical comparative evaluation of periodontally
accelerated osteogenic orthodontics with piezo and surgical
bur:  An interdisciplinary approach. J Indian Soc Periodontol
2018;22:328-33.
22. Brugnami F, Caiazzo A, Mehra P. Can corticotomy (with or
without bone grafting) expand the limits of safe orthodontic
therapy? J Oral Biol Craniofac Res 2018;8:1-6.
23. Addanki P, Gooty JR, Palaparthy R. Clinical and radiographic
comparative evaluation of buccal and palatal corticotomy
with buccal corticotomy in periodontally accelerated
osteogenic orthodontics with surgical bur. Contemp Clin Dent
2017;8:321-6.
24. Mahantesha S, Yashi P, Karan P, Ashwini S, Prashanth GS.
Wilckodontics. A novel synergy in time to save time:  A case
report. Int J Appl Dent Sci 2017;3:5-7.
25. Bahammam MA. Effectiveness of bovine-derived xenograft
versus bioactive glass with periodontally accelerated osteogenic
orthodontics in adults: A randomized, controlled clinical trial.
BMC Oral Health 2016;16:126.
26. Awasthi E, Sanjay K, Bhongade ML, Shrivastav S. Alveolar
bone housing—A modified wilkodontics approach- A  case
report. J Clin Diagn Res 2016;10:ZD12-5.
27. Charavet C, Lecloux G, Bruwier A, Rompen E, Maes N,
Limme M, et al. Localized piezoelectric alveolar decortication
for orthodontic treatment in adults: A randomized controlled
trial. J Dent Res 2016;95:1003-9.
28. Ahn HW, Seo DH, Kim SH, Park YG, Chung KR, Nelson
G. Morphologic evaluation of dentoalveolar structures of
mandibular anterior teeth during augmented corticotomy-
assisted decompensation. Am J Orthod Dentofacial Orthop
2016;150:659-69.
29. Jahanbakhshi MR, Motamedi AM, Feizbakhsh M,
Mogharehabed A. The effect of buccal corticotomy on
accelerating orthodontic tooth movement of maxillary canine.
Dent Res J (Isfahan) 2016;13:303-8.
30. Munoz F, Jiménez C, Espinoza D, Vervelle A, Beugnet J,
Haidar Z. Use of leukocyte and platelet-rich fibrin (L-PRF)
in periodontally accelerated osteogenic orthodontics
(PAOO): Clinical effects on edema and pain. J Clin Exp Dent
2016;8:e119-24.
31. Abbas NH, Sabet NE, Hassan IT. Evaluation of corticotomy-
facilitated orthodontics and piezocision in rapid canine
retraction. Am J Orthod Dentofacial Orthop 2016;149:473-80.
S106 Journal of Pharmacy and Bioallied Sciences  ¦  Volume 11  ¦  Supplement 2  ¦  May 2019
32. Wu J, Xu L, Liang C, Jiang J. Class III orthognathic surgical
cases facilitated by accelerated osteogenic orthodontics:  A
preliminary report. Aust Orthod J 2015;31:226-35.
33. Sakthi SV, Vikraman B, Shobana VR, Iyer SK, Krishnaswamy
NR. Corticotomy-assisted retraction: An outcome assessment.
Indian J Dent Res 2014;25:748-54.
34. Bhattacharya P, Bhattacharya H, Anjum A, Bhandari R,
Agarwal DK, Gupta A, et  al. Assessment of corticotomy
facilitated tooth movement and changes in alveolar bone
thickness—A CT scan study. J Clin Diagn Res 2014;8:ZC26-30.
35. Al-Naoum F, Hajeer MY, Al-Jundi A. Does alveolar
corticotomy accelerate orthodontic tooth movement when
retracting upper canines? A  split-mouth design randomized
controlled trial. J Oral Maxillofac Surg 2014;72:1880-9.
36. Krishnan P, Shetty S, Husain A. An adjunctive minor surgical
procedure for increased rate of retraction. J Pharm Bioallied
Sci 2013;5:S39-42.
37. Coscia G, Coscia V, Peluso V, Addabbo F. Augmented
corticotomy combined with accelerated orthodontic forces
in class  III orthognathic patients:  Morphologic aspects of
the mandibular anterior ridge with cone-beam computed
tomography. J Oral Maxillofac Surg 2013;71:1760.e1-9.
38. Yezdani AA. Accelerated orthodontics with alveolar
decortication and augmentation:  A case report. Orthodontics
(Chic) 2012;13:146-55.
39. Shoreibah EA, Salama AE, Attia MS, Abu-Seida SM.
Corticotomy-facilitated orthodontics in adults using a further
modified technique. J Int Acad Periodontol 2012;14:97-104.
40. Choo H, Heo HA, Yoon HJ, Chung KR, Kim SH. Treatment
outcome analysis of speedy surgical orthodontics for adults
with maxillary protrusion. Am J Orthod Dentofacial Orthop
2011;140:e251-62.
41. Nowzari H, Yorita FK, Chang HC. Periodontally accelerated
osteogenic orthodontics combined with autogenous bone grafting.
Compend Contin Educ Dent 2008;29:200-6; quiz 207, 218.
42. Lee JK, Chung KR, Baek SH. Treatment outcomes of
orthodontic treatment, corticotomy-assisted orthodontic
treatment, and anterior segmental osteotomy for bimaxillary
dentoalveolar protrusion. Plast Reconstr Surg 2007;120:1027-36.
43. Chen YW, Wang HC, Gao LH, Liu C, Jiang YX, Qu H,
et  al. Osteoclastogenesis in local alveolar bone in early
decortication-facilitated orthodontic tooth movement. PLoS
One 2016;11:e0153937.
44. Lee KB, Lee DY, Ahn HW, Kim SH, Kim EC, Roitman I. Tooth
movement out of the bony wall using augmented corticotomy
with nonautogenous graft materials for bone regeneration.
Biomed Res Int 2014;2014:347508.
45. Ahn HW, Ohe JY, Lee SH, Park YG, Kim SJ. Timing of force
application affects the rate of tooth movement into surgical
alveolar defects with grafts in beagles. Am J Orthod Dentofacial
Orthop 2014;145:486-95.
46. Yuan H, Zhu X, Lu J, Dai J, Fang B, Shen SG. Accelerated
orthodontic tooth movement following le fort I osteotomy in a
rodent model. J Oral Maxillofac Surg 2014;72:764-72.
47. Kim YS, Kim SJ, Yoon HJ, Lee PJ, Moon W, Park YG. Effect
of piezopuncture on tooth movement and bone remodeling in
dogs. Am J Orthod Dentofacial Orthop 2013;144:23-31.
48. Baloul SS, Gerstenfeld LC, Morgan EF, Carvalho RS, Van
Dyke TE, Kantarci A. Mechanism of action and morphologic
changes in the alveolar bone in response to selective alveolar
decortication-facilitated tooth movement. Am J Orthod
Dentofacial Orthop 2011;139:S83-101.