Alveolar Bone Width Before and After Periodontally Accelerated Osteogenic Orthodontics

Introduction: Periodontal accelerated osteogenic orthodontics (PAOO) has been proposed to decrease orthodontic treatment time as well as increase the width of the alveolar housing around roots of teeth in the direction of the intended tooth movement.Objective: To determine whether there was a change in alveolar bone width surrounding teeth that had undergone PAOO.Methods and Materials: Pre-op and post-op cone beam computed tomography (CBCT) scans of 4 patients who had undergone PAOO were obtained. Virtual slices of each tooth which had undergone PAOO were taken along the long axis of each tooth and measurements were made perpendicular to points at the root apex and at 2/3 the length of the tooth measured from the incisal edge (Point X). Before and after measurements of the total width of the alveolus were compared and paired t-tests were done to determine statistical significance.Results: There was an average increase of 1.04mm (range: -2.3mm - 10.73mm) around the apices 0.98mm (range: -2.61mm - 3.33mm) around point X of the measured teeth. Paired t-tests showed statistical significance for both measurements at the apex (p < 0.01) and at point X (p < 0.001). Conclusions: This study showed an average increase in alveolar bone width around teeth that had undergone PAOO; however, while there was an average increase, there were also sites in which there was a decrease in alveolar width. While it seems that PAOO can be a safe and effective treatment, like with any surgical procedure, there can still be complications and case selection is key to attaining predictable results. More prospective randomized control studies need to be done