Periodontally accelerated osteogenic orthodontics: Novel per
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Periodontally accelerated osteogenic orthodontics (PAOO) is a clinical procedure that incorporates selective corticotomy, particulate grafting, and application of optimal orthodontic forces. It reduces treatment time, increases stability of teeth, and prevents relapse of orthodontic tooth movement (OTM). The present case report, published in the Journal of Indian Society of Periodontology, highlights the technique and principles of PAOO for rapid OTM.

A 28-year-old female patient was referred to the Department of Periodontics, for corticotomy procedure for retraction space closure. Although the alignment was almost completed in anterior region, retraction space was not closed. The reason was that the tooth movement was beyond the envelope of motion which led to failure of retraction space closure. This is the perfect indication for PAOO procedure.

Intraoral examination revealed Angle's Class I molar relation. The patient was on arch expansion in maxilla. After profound anesthesia, a full-thickness mucoperiosteal flap was then elevated extending 3–4 mm beyond the mucogingival junction. With the help of piezosurgical inserts under cold saline irrigation, vertical grooves were placed in the inter-radicular space, midway between the root prominences in the alveolar bone from the distal surface of extraction space on one side to the distal surface of extraction space on the other side.

The vertical cuts extend 2–3 mm from the alveolar crest to approximately 2 mm beyond the apices of the roots. At the apical aspects of the roots, semilunar corticotomy cuts were made to join these vertical cuts [Figure 1]b. Perforations were made in the alveolar bone over the radicular surfaces with a round bur.

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