Periodontally accelerated osteogenic orthodontics combined with recombinant human bone morphogenetic protein-2: An outcome assessment

Abstract

Context: Periodontally accelerated osteogenic orthodontics (PAOO) combines alveolar corticotomy, bone graft materials, and the application of orthodontic forces for rapid correction of malocclusions. Aims: The present study aims to primarily assess differences in orthodontic treatment duration, bone quality around corticotomy sites, postoperative healing, and subjective pain when corticotomy was done conventionally and with the placement of recombinant human bone morphogenetic protein-2 (rhBMP-2). Settings and Design: Thirty individuals participated in this study. Individuals were randomly assigned into each of the following experimental groups; C + BMP: Corticotomy with 0.5 μg/mL rhBMP-2 and C: Corticotomy only. Materials and Methods: Clinical parameters included recording the duration of the treatment period, visual analog scale scores and early wound healing index scores. The evaluation of bone density was performed at baseline, 3 months, and 6 months by using RVG. Statistical Analysis Used: Two-way analysis of variance and post hoc multiple comparison tests were used to compare data between test and control groups at different time points. Results: rhBMP-2 application was effective in reducing the overall treatment time and resulted in an increase in bone density around corticotomy sites at the end of the treatment period when compared to conventional corticotomy procedure. Placement of rhBMP-2 neither delayed wound healing nor affected participant pain scores. Conclusions: From this trial conducted over a period of 6 months, rhBMP-2 has the potential to function as a regenerative material in PAOO.

The Effectiveness of Periodontally Accelerated Osteogenic Orthodontics (PAOO) in Accelerating Tooth Movement and Supporting Alveolar Bone Thickness During Orthodontic Treatment: A Systematic Review

“…Six trials evaluated the decrowding of lower and/or upper anterior teeth [ 17 , 19 , 29 , 31 - 33 ]. Four of them included non-extraction treatment with minimal to moderate maxillary and/or mandibular anterior crowding [ 17 , 28 , 29 , 32 ].…”

“…Allograft was employed in two trials [ 29 , 30 ], xenograft in two trials [ 17 , 19 ], synthetic bone substitutes in four trials [ 17 , 18 , 28 , 32 ] and composite grafts in one trial [ 31 ]. Regarding the primary outcomes, eight articles assessed the duration of orthodontic treatment [ 17 - 19 , 28 - 32 ], three articles assessed bone density using periapical radiographs [ 17 , 31 ] or panoramic radiographs [ 32 ], and one article assessed the alveolar thickness using a CT scan [ 27 ]. On the other hand, the secondary outcomes included clinical probing depth assessment in three studies and were dependent on using a periodontal probe [ 17 , 29 , 32 ].…”

Evaluation of the Levels of Pain, Discomfort, Functional Impairments and Satisfaction With the Periodontally Accelerated Osteogenic Orthodontics (PAOO) When Leveling and Aligning Crowded Teeth: A Prospective Cohort Study

“…The pain was severe on the first day due to trauma and edema as a result of the surgery. Also, 25% of patients had severe pain and took painkillers heavily during the first week following surgery; whereas a clinical trial by Chandra et al showed that the pain level was moderate immediately after surgery in the PAOO group compared to the traditional corticotomy group without any significant difference between them [ 19 ]. It should be noted that Chandra et al assessed the level of pain immediately after surgery and this did not reflect the actual pain level due to the persistence of the local anesthetic effect.…”

Retrograde nerve growth factor signaling modulates tooth mechanical hyperalgesia induced by orthodontic tooth movement via acid-sensing ion channel 3

“… 4 The resulting pro-inflammatory mediators, e.g., H + and BMP-2, on one hand initiate local bone remodeling and on the other hand bond to nerve terminals to elicit painful sensations and mechanical hyperalgesia. 12 , 15 , 16 Tooth mechanical hyperalgesia is the most prominent symptom associated with tooth movement, manifested with biting or chewing pain and masticatory disturbance. 3 In our previous study, we invented the methods of using bite force for the evaluation of mechanical hyperalgesia induced by tooth movement and validated the viability and reliability of this method.…”