Biography
Biography: A Arif Yezdani
Abstract
The various methods to accelerate orthodontic tooth movement are surgical methods, physical/mechanical stimulation
methods like, low level laser therapy, resonance vibration, magnetic fields and electric current. Molecular methods,
pharmacological agents and hormones too play a vital role in accelerating orthodontic tooth movement. Wilckodontics, an
amalgamation of two time-tested procedures, namely, selective alveolar decortication and periodontal alveolar augmentation
collectively called Accelerated Osteogenic Orthodontics (AOO) in conjunction with efficient orthodontic bio-mechanics,
paved the way for rapid tooth movement with shortened treatment duration. Professional adults and adolescents desirous
of quick orthodontic treatment sans the long stretched treatment duration interspersed with multitude of appointments,
are potential candidates for this procedure. AOO exploits the dynamics of bone physiology and stimulates and harnesses
the innate potential of living bone. It is a procedure wherein selective decortication of alveolar bone is done which in turn
induces an increase in hard and soft tissue turnover by a process known as RAP (Regional Acceleratory Phenomenon) that
potentiates tissue organization and healing. The cancellous portion of the alveolar bone is induced into a more pliable, transient
demineralized state called osteopenia by osteoclastic activity. This catabolic process is followed by an anabolic process wherein
new bone is formed and the osteoid matrix begins to mineralize. This demineralization-remineralization phenomenon
facilitates rapid tooth movement. The RAP commences a few days after surgery, peaks between 1-2 months when catabolic
and anabolic responses are 3-fold higher, dissipates to a normal steady state by 11 weeks after surgery, and takes about 6-24
months to resolve completely. The periodontal alveolar augmentation with a bone graft improves the structural integrity of
the periodontium. It augments, reshapes, and provides additional bone support and in certain situations provides a degree
of improvement in lip posture too. Pre-existing alveolar fenestrations over root prominences are effectively eliminated, thus
reducing the probability of bony dehiscence formation. The advantages of AOO are that there is effective maintenance of
an adequate zone of gingival attachment with no gingival recession or probing depths greater than 3mm, good presence of
interdental papillae and loss of tooth vitality or significant reduction in radiographic height of neither crestal bone nor apical
root resorption. Relapse is minimized as the volume of the alveolar housing is increased with the bone graft. Initial lack of
mineralization is adequately compensated with continued mineralization in the retention period. Since overall treatment time
is reduced, bacterial time-load factors is also reduced with consequent decrease in infection and incidence of dental caries. A
couple of cases are shown to highlight the AOO procedure, which is inveritably an indispensable adjunct in an orthodontist’s
armamentarium.