Commentary on: periodontally accelerated osteogenic orthodontics (PAOO) - a clinical dilemma

Abstract

It is apparent that tooth movement is enhanced by procedures that elevate the remodeling of alveolar bone, and of periodontal and gingival fibrous tissues. The periodontally accelerated osteogenic orthodontics (PAOO) also termed as Wilckodontics, involves full-thickness labial and lingual alveolar flaps accompanied with limited selective labial and lingual surgical scarring of cortical bone (corticotomy). Most of the authors suggest that the RAP is the major stimulus for alveolar bone remodeling, enabling the PAOO. However, we propose that detachment of the bulk of dentogingival and interdental fibers from coronal part of root surfaces by itself should suffice to stimulate alveolar bone resorption mainly on its PDL surfaces, leading to widening of the periodontal ligament space which largely attributes to accelerated osteogenic orthodontics. Moreover this limited fiberotomy also disrupts transiently the positional physical memory of dentition (PPMD), allowing accelerated tooth movement. During retention period, a new biological and physical connectivity is generated that could be termed as new positional memory of the dental arch.