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

Pacific Coast Society of Orthodontists Bulletin Spring 2013

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