Volume : 7, Issue : 1, January - 2018

Periodontally Accelerated Osteogenic Orthodontics(Paoo): A Novel Rapid Approach

Ila Tiwari

Abstract :

<p>&nbsp; Wilckodontics&rsquo;, also known as Periodontally Accelerated Osteogenic Orthodontics (PAOO) is a relatively new treatment in the dental realm. It is a clinical procedure that combines selective alveolar corticotomy, particulate bone grafting and the application of orthodontic forces. Basically it is a combination of selective decortication facilitated orthodontic technique and alveolar augmentation.1&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp; This procedure is theoretically based on the bone healing pattern known as the regional acceleratory phenomenon (RAP).2&nbsp; Regional acceleratory phenomenon was developed by Frost and Jee in 19833,4. The decortication of bone results in an increased turnover of alveolar spongiosa with areas of alveolar demineralization. This results in osteopenia, where its mineral content temporarily decreased which enables teeth to be moved more rapidly and further through the collagenous soft tissue matrix of the bone . Following the completion of orthodontic treatment, remineralization takes place resulting in greater stability in the orthodontic treatment outcome. &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Dr. Thomas Wilcko (Periodontist) and William Wilcko (Orthodontist), of Erie, PA in 1995 further modified the corticotomy assisted orthodontic technique with the addition of alveolar augmentation and named the procedure as Periodontally Accelerated Osteogenic Orthodontics (PAOO) &nbsp;later patented as &ldquo;Wilckodontics&rdquo; based on the emerging concepts of Wilcko others. &nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; This procedure has been shown to be particularly effective in treating moderate to severe crowding, in Class II malocclusions requiring expansion or extractions, and mild Class III malocclusions. As long as healthy periodontium is present, PAOO can be done at any age (from 11 years to 77 years of age)6</p>