Corticotomy-Assisted Orthodontic Treatment
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Corticotomy-Assisted Orthodontic Treatment |
Corticotomy-Assisted Orthodontic Treatment
Recently, Wilcko developed a patented technique called Accelerated Osteogenic Orthodontics (AOO) or Periodontally Accelerated Osteogenic Orthodontics (PAOO) This technique is similar to conventional corticotomy except that selective decortication in the form of lines and points is performed over all of the teeth that are to be moved. In addition, a resorbable bone graft is placed over the surgical sites to augment the confining bone during tooth movement. After a healing period of one or two weeks, orthodontic tooth movement is started and then followed up using a faster rate of activation at two week intervals
Using this technique, Wilcko reported rapid tooth movement at a rate of 3 to 4 times greater than conventional orthodontic movement, which was attributed to a state of reduced mineralization (reversible osteopenia) of the alveolar bone surrounding the involved teeth during the orthodontic movement and not to bony block movement, as claimed by Köle . Wilcko explained the concept of reversible osteopenia in a study of five patients using computed tomographic imaging . After corticotomy, demineralization occurs in the alveolar bone and the remaining collagenous matrix of the bone is transported with the tooth during its movement. The matrix then remineralizes after the orthodontic movement. This introduced new concepts to the CAOT field, including bone matrix transportation and osteopenia-facilitated rapid tooth movement
Corticotomy-assisted orthodontic treatment is an established and efficient orthodontic technique that has recently been studied in a number of publications. It has gradually gained popularity as an adjunct treatment option for the orthodontic treatment of adults. It involves selective alveolar decortication in the form of decortication lines and dots performed around the teeth that are to be moved. It is done to induce a state of increased tissue turnover and a transient osteopenia, which is followed by a faster rate of orthodontic tooth movement. This technique has several advantages, including faster tooth movement, shorter treatment time, safer expansion of constricted arches, enhanced post-orthodontic treatment stability and extended envelope of tooth movement. The aim of this article is to present a comprehensive review of the literature, including historical background, contemporary clinical techniques, indications, contraindications, complications and side effects.
CONCLUSION
CAOT is a promising technique that has many applications in the orthodontic treatment of adults because it helps to overcome many of the current limitations of this treatment, including lengthy duration, potential for periodontal complications, lack of growth and the limited envelope of tooth movement. The mechanism behind CAOT can be summarized as the induction of bone metabolism via decortication lines and points around the teeth to be moved to enhance bone and periodontal turnover, resulting in a transient stage of osteopenia during treatment. This enhances and accelerates tooth movement if followed by a short period of orthodontic appliance treatment. PAOO effects and mechanism were confirmed by recent well designed histological studies. However, further randomized testing in humans is still needed to confirm the claimed advantages of this technique and to evaluate the long term effects.
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