A Multidisciplinary Approach to space closure in adult orthodontic patient : A case report using PAOO
Keywords:
Periodontally Accelerated Osteogenic Orthodontics, corticotomy, orthodontic space closure, regional acceleratory phenomenon (RAP), interdisciplinary therapy
Abstract
AbstractPeriodontally Accelerated Osteogenic Orthodontics (PAOO) is an interdisciplinary procedure that combines selective alveolar corticotomy, bone grafting, and orthodontic force application to accelerate tooth movement through the regional acceleratory phenomenon (RAP). This technique significantly reduces treatment duration while maintaining periodontal stability. This report presents the case of a 19-year-old female who reported to the Department of Periodontology with a persistent extraction space between the maxillary right canine and second premolar, four months after extraction of the first premolar. Conventional orthodontic mechanics failed to close the space. PAOO was performed in the first quadrant, followed by immediate orthodontic activation. Healing was uneventful, and complete space closure was achieved. Radiographic evaluation confirmed periodontal stability with no root resorption. The case highlights the effectiveness of PAOO in managing orthodontic space closure in adults and underscores the value of interdisciplinary care.
References
References
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7. Advanced Periodontal Surgical Techniques --- Sierge Dibart(2nd edition )
8. 4. Wilcko WM, Wilcko T, Bissada NF. An evidence based analysis of periodontally accelerated orthodontic and osteogenic techniques: A synthesis of scientific perspectives. Semin Orthod 2008;14:305-16.
9. . Schilling T, Müller M, Minne HW, Ziegler R. Influence of inflammation-mediated osteopenia on the regional acceleratory phenomenon and the systemic acceleratory phenomenon during healing of a bone defect in the rat. Calcif Tissue Int. 1998;63:160-6
10. Jedliński M, Romeo U, Del Vecchio A, Palaia G, Galluccio G. Comparison of the effects of photobiomodulation with different lasers on orthodontic movement and reduction of the treatment time with fixed appliances in novel scientific reports: a systematic review with meta-analysis. Photo Photo Laser Surg 2020;38(8):455–65.
11. Zuppardo ML, Santamaria M, Ferreira CL, Longo M, Cirelli JA, Santamaria MP, et al. Effect of two corticotomy protocols on periodontal tissue and orthodontic movement. J Appl Oral Sci 2020;28:e20190766.
12. Bakdach WMM, Hadad R. Effectiveness of low-level laser therapy in accelerating the orthodontic tooth movement: a systematic review and meta-analysis. Dent Med Probl 2020;57(1):73–94.
13. Attri S, Mittal R, Batra P, Sonar S, Sharma K, Raghavan S, et al. Comparison of rate of tooth movement and pain perception during accelerated tooth movement associated with conventional fixed appliances with micro-osteoperforations - a randomised controlled trial. J Orthod 2018;45(4):225–33.
14. Charavet C, Lecloux G, Jackers N, Maes N, Lambert F. Patient-reported outcomes measures (PROMs) following a piezocision-assisted versus conventional ortho dontic treatments: a randomized controlled trial in adults. Clin Oral Investig 2019;23(12):4355–63.
15. Nowzari H, Yorita FK, Chang HC. Periodontally accelerated osteogenic orthodontics combined with autogenous bone grafting. Compend Contin Educ Dent. 2008;29(4):200–6.
16. Murphy KG, Wilcko MT, Wilcko WM, Ferguson DJ. Periodontal accelerated osteogenic orthodontics: A description of the surgical technique. J Oral Maxillofac Surg. 2009;67(10):2160–6.
.
17. Wilcko WM, Wilcko MT. Accelerated osteogenic orthodontics: rapid orthodontics with alveolar reshaping. In: Davidovitch Z, Mah J, editors. Biological Mechanisms of Tooth Eruption, Resorption and Replacement by Implants. Harvard Society for the Advancement of Orthodontics; 2007. p. 345–50.
18. Frost HM. The regional acceleratory phenomenon: a review. Henry Ford Hosp Med J. 1983;31(1):3–9.
19. AlGhamdi AS. Corticotomy facilitated orthodontics: Review of a technique. Saudi Dent J. 2010;22(1):1–5.
20. Hassan AH, Al-Fraidi AA, Al-Saeed SH. Corticotomy-assisted orthodontic treatment: review. Open Dent J. 2010;4:159–64.
21. Leethanakul C, Kanpiputana R, Pongpanich S, Pitiphat W, Rattanayatikul C. Factors affecting outcomes of periodontally accelerated osteogenic orthodontics. J Periodontol. 2014;85(6):868–76.
22. Hoogeveen EJ, Jansma J, Ren Y. Surgically facilitated orthodontic treatment: A systematic review. Am J Orthod Dentofacial Orthop. 2014;145(4 Suppl):S51–64.
23. Patterson BM, Dalci O, Darendeliler MA, Papadopoulou AK. Corticotomies and orthodontic tooth movement: A systematic review. J Oral Maxillofac Surg. 2016;74(3):453–73.
24. Vercellotti T, Podesta A. Orthodontic microsurgery: a new surgically guided technique for dental movement. Int J Periodontics Restorative Dent. 2007;27(4):325–31.
25. Dibart S, Sebaoun JD, Surmenian J. Piezocision: a minimally invasive, periodontally accelerated orthodontic tooth movement procedure. Compend Contin Educ Dent. 2009;30(6):342–50.
1. Hassan A, Al-Fraidi A and Al-Saeed S. Corticotomy-assisted orthodontic treatment: Review. The Open Dentistry Journal 2010;4:159 -164.
2. 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.
3. Wilcko WM, Wilcko MT, Bouquot JE, Ferguson DJ. Rapid orthodontics with alveolar reshaping: two case reports of decrowding. Int J Periodontics Restorative Dent. 2001;21(1):9–19.
4. Hajji SS The influence of accelerated osteogenic response on mandibular decrowding (thesis). St Louis University; 2009
5. Frost HM: The regional acceleratory phenomenon: a review. Henry Ford Hosp Med J 1983; 31: 3–9.
6. Eriksen EF, Gundersen HJ, Melsen F, Mosekilde L: Reconstruction of the for mative site in iliac trabecular bone in 20 normal individuals employing a kinetic model for matrix and mineral apposi tion. Metab Bone Dis Relat Res 1984; 5: 243–252.
7. Advanced Periodontal Surgical Techniques --- Sierge Dibart(2nd edition )
8. 4. Wilcko WM, Wilcko T, Bissada NF. An evidence based analysis of periodontally accelerated orthodontic and osteogenic techniques: A synthesis of scientific perspectives. Semin Orthod 2008;14:305-16.
9. . Schilling T, Müller M, Minne HW, Ziegler R. Influence of inflammation-mediated osteopenia on the regional acceleratory phenomenon and the systemic acceleratory phenomenon during healing of a bone defect in the rat. Calcif Tissue Int. 1998;63:160-6
10. Jedliński M, Romeo U, Del Vecchio A, Palaia G, Galluccio G. Comparison of the effects of photobiomodulation with different lasers on orthodontic movement and reduction of the treatment time with fixed appliances in novel scientific reports: a systematic review with meta-analysis. Photo Photo Laser Surg 2020;38(8):455–65.
11. Zuppardo ML, Santamaria M, Ferreira CL, Longo M, Cirelli JA, Santamaria MP, et al. Effect of two corticotomy protocols on periodontal tissue and orthodontic movement. J Appl Oral Sci 2020;28:e20190766.
12. Bakdach WMM, Hadad R. Effectiveness of low-level laser therapy in accelerating the orthodontic tooth movement: a systematic review and meta-analysis. Dent Med Probl 2020;57(1):73–94.
13. Attri S, Mittal R, Batra P, Sonar S, Sharma K, Raghavan S, et al. Comparison of rate of tooth movement and pain perception during accelerated tooth movement associated with conventional fixed appliances with micro-osteoperforations - a randomised controlled trial. J Orthod 2018;45(4):225–33.
14. Charavet C, Lecloux G, Jackers N, Maes N, Lambert F. Patient-reported outcomes measures (PROMs) following a piezocision-assisted versus conventional ortho dontic treatments: a randomized controlled trial in adults. Clin Oral Investig 2019;23(12):4355–63.
15. Nowzari H, Yorita FK, Chang HC. Periodontally accelerated osteogenic orthodontics combined with autogenous bone grafting. Compend Contin Educ Dent. 2008;29(4):200–6.
16. Murphy KG, Wilcko MT, Wilcko WM, Ferguson DJ. Periodontal accelerated osteogenic orthodontics: A description of the surgical technique. J Oral Maxillofac Surg. 2009;67(10):2160–6.
.
17. Wilcko WM, Wilcko MT. Accelerated osteogenic orthodontics: rapid orthodontics with alveolar reshaping. In: Davidovitch Z, Mah J, editors. Biological Mechanisms of Tooth Eruption, Resorption and Replacement by Implants. Harvard Society for the Advancement of Orthodontics; 2007. p. 345–50.
18. Frost HM. The regional acceleratory phenomenon: a review. Henry Ford Hosp Med J. 1983;31(1):3–9.
19. AlGhamdi AS. Corticotomy facilitated orthodontics: Review of a technique. Saudi Dent J. 2010;22(1):1–5.
20. Hassan AH, Al-Fraidi AA, Al-Saeed SH. Corticotomy-assisted orthodontic treatment: review. Open Dent J. 2010;4:159–64.
21. Leethanakul C, Kanpiputana R, Pongpanich S, Pitiphat W, Rattanayatikul C. Factors affecting outcomes of periodontally accelerated osteogenic orthodontics. J Periodontol. 2014;85(6):868–76.
22. Hoogeveen EJ, Jansma J, Ren Y. Surgically facilitated orthodontic treatment: A systematic review. Am J Orthod Dentofacial Orthop. 2014;145(4 Suppl):S51–64.
23. Patterson BM, Dalci O, Darendeliler MA, Papadopoulou AK. Corticotomies and orthodontic tooth movement: A systematic review. J Oral Maxillofac Surg. 2016;74(3):453–73.
24. Vercellotti T, Podesta A. Orthodontic microsurgery: a new surgically guided technique for dental movement. Int J Periodontics Restorative Dent. 2007;27(4):325–31.
25. Dibart S, Sebaoun JD, Surmenian J. Piezocision: a minimally invasive, periodontally accelerated orthodontic tooth movement procedure. Compend Contin Educ Dent. 2009;30(6):342–50.
Published
2026-01-03
How to Cite
Gupta, D., Dr. kanchan Yadav, Dr. Nishant Chauhan, & Dr. Snehal Singh. (2026). A Multidisciplinary Approach to space closure in adult orthodontic patient : A case report using PAOO. UNIVERSITY JOURNAL OF DENTAL SCIENCES, 12(1). https://doi.org/10.21276/ujds.2026.12.1.13
Section
Case Reports
