Periodontally Accelerated osteogenic orthodontics (PAOO) / Alveolar osteogenic orthodontics/ Regional accelerated phenomenon (RAP)

What is it?

It combines selective alveolar corticotomy, bone grafting along with application of orthodontic forces. This accelerates tooth movement 2-3 times faster than the traditional orthodontic treatment.

Who all will need RAP/PAOO ?

RAP is suitable for any age group with healthy gums and bone (from 11 years to 77 years of age). It is also suitable for people who wish to decrease their treatment time.

Who should act first? Orthodontist or Periodontist?

After performing PAOO, orthodontic treatment initiated within 2 weeks after surgery.

The orthodontist has a limited amount of time to speed up tooth movement. This period is usually 4 to 6 months, after which finishing movements occur with a normal speed.

Preoperative view

Preoperative view

After phase I therapy, full thickness mucoperiosteal flap was elevated till mucogingival junction irt 35 36 37 region under local anesthesia

After phase I therapy, full thickness mucoperiosteal flap was elevated till mucogingival junction irt 35 36 37 region under local anesthesia

Vertical decortications are given along the buccal aspect extending 2 to 3mm below the crest of the bone to a point 2mm beyond the apices of the roots

Vertical decortications are given along the buccal aspect extending 2 to 3mm below the crest of the bone to a point 2mm beyond the apices of the roots

Bone grafts was packed in the corticotomy site

Bone grafts was packed in the corticotomy site. Material of choice- Decalcified freeze-dried bone allograft (DFDBA), bio oss, autogenous bone, deproteinized bovine graft

GTR membrane was placed over the bone graft Other material of choice will include PRF, PRP, growth factors

GTR membrane was placed over the bone graft Other material of choice will include PRF, PRP, growth factors

Vertical decortications are given along the buccal aspect extending 2 to 3mm below the crest of the bone to a point 2mm beyond the apices of the roots

Vertical decortications are given along the buccal aspect extending 2 to 3mm below the crest of the bone to a point 2mm beyond the apices of the roots

Flap margins are approximated using 3-0 black silk suture

Flap margins are approximated using 3-0 black silk suture

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