Dentaltown July 2018 - 65

While many mechanical aspects of treatment available today
facilitate tooth movement, historically the only option for
speeding up the process involved surgical intervention such
as osteogenesis, corticotomy or osteotomy.1 To enable
greater tooth movement in less time, I prefer minimally
invasive options, such as micro-osteoperforation
(MOP), in conjunction with both traditional
orthodontics and clear aligner therapy. I
also incorporate high frequency vibration
(HFV) into my practice to improve
patient aligner seating, which may
translate to more predictable tooth
movement-and reduced pain when
switching aligners.
MOP was shown in one study to
accelerate the rate of tooth movement 2.3
times faster than without the treatment.2 In
my experience, this procedure is especially
helpful for effective tooth movements, as well as
for patients who need a combination of orthodontic and
restorative treatments that could take 12-24 months before they even
begin their restorative phase. This waiting period can be discouraging
and can also result in the patient forgoing necessary treatment.
MOP produces little to no discomfort or swelling. Before treatment,
the patient can be treated with an effective topical anesthetic gel, or with
minimal infiltration and a chlorhexidine rinse for 60 seconds before and
after treatment. If patients need an analgesic for minor discomfort after
MOPs, they should be advised to take acetaminophen; NSAIDs such
as aspirin and ibuprofen should be avoided because they inhibit the
inflammatory effect of MOP and reduce its effectiveness.3

Fig. 1: Initial photos. Malocclusion: canted edge-to-edge
posterior open bite, anterior open bite greater than 3mm
and a midmaxillary facial deficiency. Patient was treated with
reactive micro-osteoperforation (MOP) treatments at month
4 and month 8. Expected treatment time: 22 months. Actual
treatment time with MOP: 13 months.

MOP: Getting teeth back on track
For patients who have challenging orthodontic issues, MOP has
successfully affected their treatment goals. For example, one patient who
came to my office after previous orthodontic treatment presented with
an anterior 3mm open bite from first molar to first molar with posterior
occlusion only on the second molars, a bilateral posterior crossbite and
an anterior maxillary cant up on the right side (Fig. 1). While he wanted
a cosmetic solution to his issues, he did not want wires and brackets
or surgical intervention. This posed a common clear aligner challenge
clinicians face with open bites. The relative extrusions required were
beyond the 2mm aligners can typically deliver, and the goal was to close
the posterior open bite and land him on a more functional position to
eliminate the edge-to-edge bite.

Fig. 2: Day of and immediately after second MOP treatment.

dentaltown.com \\ JULY 2018

65



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Table of Contents for the Digital Edition of Dentaltown July 2018

Dentaltown July 2018 - Intro
Dentaltown July 2018 - Cover1
Dentaltown July 2018 - Cover2
Dentaltown July 2018 - 1
Dentaltown July 2018 - 2
Dentaltown July 2018 - 3
Dentaltown July 2018 - 4
Dentaltown July 2018 - 5
Dentaltown July 2018 - 6
Dentaltown July 2018 - 7
Dentaltown July 2018 - 8
Dentaltown July 2018 - 9
Dentaltown July 2018 - 10
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Dentaltown July 2018 - 12
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Dentaltown July 2018 - 16
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Dentaltown July 2018 - 18
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Dentaltown July 2018 - 20
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Dentaltown July 2018 - Cover3
Dentaltown July 2018 - Cover4
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