ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Accelerated Orthodontic Tooth Movement in Young Patients
Clinical Question With a malocclusion, is a surgical treatment known as “Accelerated Osteogenic Orthodontics” a periodontally safe procedure to accelerate orthodontic tooth movement in young patients?
Clinical Bottom Line Application of the treatment process of “Accelerated Osteogenic Orthodontics” is safe and does not compromise periodontal health in young patients in need of orthodontic treatment. (See Comments on the CAT below)
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 11829041 Wilcko/2001Female (17 y.o) and Male (24)Case Reports
Key resultsKey results were combined and are listed below.
#2) 19761908WIlcko/2009Female (23) and Male (47)Case Reports
Key resultsBoth articles conclude that the use of the “regionally accelerated phenomena” used in Accelerated Osteogenic Orthodontics provided excellent esthetic results and stable orthodontic tooth movement. It was reported that there was no compromise in periodontal health, including no significant root resorption, fenestrations or adverse effects in alveolar bone volume.
Evidence Search PubMed search with keywords “Malocclusion"[MeSH] AND "Tooth Movement"[MeSH] AND "Orthodontic brackets" [MeSH] AND "Adolescent" [MeSH] AND "Alveolar process"[MeSH]
Comments on
The Evidence
Both studies were case studies involving patients that received orthodontic surgical procedures involving “rapidly accelerated phenomena” to accelerate the movement of teeth through the alveolar bone. The procedures required adequate compliance and follow-up in order to receive full treatment and report any post-treatment periodontal/orthodontic problems.
Applicability Orthodontists. However, it is only a case study of two patients, and so more trials/studies would be needed to positively answer the PICO question. The second article, it is a case study that mostly describe the procedures and gives a rather succinct synopsis on its effects on periodontal side effects. The results must be considered with caution given the low level of evidence from case reports.
Specialty/Discipline (General Dentistry) (Oral Surgery) (Orthodontics)
Keywords
ID# 629
Date of submission: 05/03/2010spacer
E-mail trandt@livemail.uthscsa.edu
Author Dennis Tran
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Dubravko Pavlin, DMD, PhD
Faculty mentor/Co-author e-mail PAVLIN@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
by Peter Gakunga, DDS, DMD (San Antonio, Texas) on 09/05/2012
The biological basis for this treatment modality is the surgically-induced demineralization-remineralization dynamics which facilitate the rapid tooth movement (publication PMID: 18771369). Three weeks after selective alveolar decortication in rats, there is an increase in the turnover of alveolar spongiosa. The catabolic activity (osteoclast count) and anabolic activity (apposition rate) are three times greater. Calcified spongiosa decreases by two-fold and PDL surface increases by two-fold. This increase in bone turnover levels to a steady state by the eleventh week after surgery.
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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by Meenakshi Vishwanath (San Antonio,Texas) on 07/18/2012
I conducted a PubMed search on this topic and found one more article (PMID: 18719214 ) testing the theory of surgically assisted orthodontic therapy or regional acceleratory phenomenon using comparative study on rats. This study finds the same results as published in this CAT but adds further documentation.
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