Research Progress Of Periodontal Accelerated Osteogenesis Orthodontics And Series Of Case Reports

Background:Periodontal accelerated osteogenesis orthodontic(PAOO)is a technique involving combination of a selective decortication facilitated orthodontic technique and alveolar augmentation.PAOO has several advantages,including acceleration of tooth movement,reduction of treatment time,less root resorption,enhancement of alveolar thickness,differential tooth movement and more post-orthodontic stability.It has been a hundred years since the introduction of CAOT.PAOO evolved from the CAOT.In the past 20 years,PAOO has rapidly developed from a niche surgery to a widely used in clinic.During this period,its operation and application have experienced continuous development and improvement.Orthodontists need to use CBCT to evaluate the alveolar bone before treatment,and accurately locate the boundary of alveolar bone,so as to evaluate the risk of orthodontic process and decide whether PAOO is necessary;PAOO surgeons also need to design the operation plan according to this to avoid unnecessary iatrogenic injury during operation.However,there are some differences in the quantitative measurement of alveolar bone by CBCT.Therefore,we evaluated the accuracy of quantitative measurement of thin alveolar bone height and identification of bone defects by CBCT,and provided an error reference for clinical measurement of alveolar bone by CBCT.Methods:Literature review of PAOO combine with cases,give a detailed introduction to the development history,surgical progress,clinical application and efficacy of PAOO,combined with the experience to discuss the details.The sample consisted of 28 teeth(thickness ≤1mm)in 6 patients who accepted PAOO through clinical examination,the distance from alveolar ridge crest to CEJ and incidence of dehiscence and fenestrations were measured both directly,with a gauge during surgery,and indirectly by CBCT scans before treatment.Direct data were regarded as the gold standard,and indirect data were analyzed to evaluate the accuracy of CBCT for measuring alveolar height and detecting dehiscences and fenestrations.Results:1.PAOO can provide an increased net alveolar volume,ensure the safety of orthodontic therapy,the greater alveolar volume eliminates bony dehiscence and fenestrations under most circumstances,providing for a more structurally healthy periodontium and increased post-orthodontic stability.It can assist cleft patients to expanse the dentoalveolar ridge;it can assist space closure in cases whose alveolar ridge atrophy was obvious after extraction and significantly shorten the treatment time.2.For thin alveolar bone(thickness ≤1mm),CBCT overestimated the distance from alveolar ridge crest to CEJ by 1.6mm on average(P<0.05).The accuracy of dehiscence was 75%;the accuracy of fenestration was 98%.Conclusion:1.PAOO overcomes many shortcomings of traditional orthodontic methods,and has the advantages of accelerating tooth movement,shortening treatment,improving periodontal phenotype,enhancing postoperative stability etc.2.The ability of CBCT detect the thin alveolar bone is poor,overestimated the distance from alveolar ridge crest to CEJ;May lead false positive diagnosis of bone dehiscence when observing bone defect with CBCT.