Pacific Coast Society of Orthodontists Bulletin Spring 2013 - (Page 34)
SUMMARIES
ANNUAL SESSION
ACCELERATED OSTEOGENIC
ORTHODONTIC (AOO) SYSTEM—
PHYSIOLOGICAL BENEFITS
AND INCREASED RANGE OF MOVEMENT
Presented by William M. Wilcko, DMD, MS and M. Thomas Wilcko, DMD
at the PCSO Annual Session, October 6, 2012.
Summarized by Charity Siu, DMD, PCSO Bulletin Northern Region Editor
T
he Drs. Wilcko are
brothers; William
is an orthodontist,
and Thomas is a periodontist.
Due to their relationship and
expertise, they look at the
practice of orthodontics with
a different perspective, and
have been able to increase the
scope of treatment with an
increased stability of results.
Dr. W. Wilcko
The two key words to remember are: accelerated and osteogenic. With the emergence
of new bone materials, Dr. Wilco asserts that orthodontic
movement can be more efficient.
Corticotomy is a surgical disturbance of the cortical plate
(decortication). It changes the physiology of the bone,
tricking it to think it is broken—which causes an increase
in the rate of demineralization and remineralization. The
amount of remineralization is dependent on the amount
of insult to the bone; hence, small dots are cut into the
bone. (This also provides blood supply for the overlying
bone grafting material.) The final result is that teeth under
orthodontic pressures will move faster. With respect to
the method of cutting into the bone, it is not necessary to
create a pattern, but dots and the avoidance of heat are
preferred .
The Drs. Wilcko presented the clinical case of a class I
patient with crowding; they faced a borderline decision
to extract or not to extract. In this situation, they did
not extract because they moved the teeth irrespective
of the bone. Appliances were placed on the teeth. They
laid a full-thickness flap on the buccal and lingual of
all the teeth, performed the
corticotomy, added grafting
material, and sutured the
flaps back in place. Peak
demineralization occurs
at four weeks postsurgery.
Adjustment appointments
were two weeks apart, and
treatment was completed
in six months. They used
similar wire sequences,
Dr. T. Wilcko
forces applied, and retention
protocols as in their non-surgical patients. Examination
of the patients who underwent treatment showed no
proclination of incisors, no root resorption, and more
stable long-term results, despite less retainer wear. These
patients also did not need posttreatment circumferential
supracrestal fibrotomy.
Examples of applications for this technique—other than
for full mouth treatment—include:
∑
Anchorage: Avoid cutting into the bone surrounding
the teeth that you want to serve as anchorage.
∑
Impacted teeth: Cutting the bone around impacted
teeth creates a path for eruption.
Despite our attempts to avoid letting our patients dictate
their treatment, the demand for accurate treatment done
efficiently is ever growing. With the aid of surgery
and bone grafting, we can offer patients the best result
possible within a shorter time period. The Drs. Wilcko
have been on the forefront of orthodontic treatment
assisted by bone biology.
S
34
PCSO BULLETIN • SPRING
2013
Table of Contents for the Digital Edition of Pacific Coast Society of Orthodontists Bulletin Spring 2013
Dental Ethics
Save a Little and Invest a Lot
Plan for Ongoing Success
AAO Trustee's Report
PCSO Business
AAOF Report
Component Report
PCSO at a Glance
Dr. Terry McDonald Interviews Dr. Harry (Hap) Doughterty, Jr.
Case Report Pre-Treatment
Dr. John Ive
3-D Image-Aided Treatment of Impacted and Transposed Teeth
Controversies in Orthodontics
DIY Technology Upgrades on a DIY Budget
Accelerated Osteogenic Orthodontic (AOO) System -- Physiological Benefits and Increased Range of Movement
Case Report Post-Treatment
Pearls from Idaho: Holding 3-3 Retainers While Bonding
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