Effectiveness of modified periodontally accelerated osteogenic orthodontics in skeletal class II malocclusion treated by a camouflage approach

Skeletal Class II malocclusion is a complex orofacial condition. Here, we translated the single clinical problem to a multidisciplinary approach that combined the periodontal surgery, biomaterial implantation, and orthodontics to treat this condition. This study aimed to explore the clinical effectiveness of modified periodontally accelerated osteogenic orthodontics (PAOO) in adult patients with skeletal Class II discrepancy via a camouflage orthodontic approach. This clinical trial has been registered in the Chinese Clinical Trial Registry (trial number: ChiCTR2100052638, trial URL: http://www.chictr.org.cn/showproj.aspx?proj=135827). A total of 26 adult female patients with similar skeletal Class II malocclusions and similar dental and skeletal discrepancies were enrolled. A total of 13 patients in the experimental group received modified PAOO characterized by vertical incisions in interradicular areas and random punching made by a piezoelectric device, whereas 13 patients in the control group received orthodontic treatment only. All patients underwent extraction of four premolars and orthodontic treatment with the sliding MBT straight-wire technique. Treatment courses were recorded and changes in dental and skeletal parameters were evaluated by cephalometric analysis and translated into upper digital cast for further measurements. The results showed that the durations of the alignment and leveling stage (4.51??1.53 mos versus 9.41??1.46 mos. P<0.01), space closing stage (13.56??2.57 mos versus 17.09??3.50 mos. P<0.05) and total treatment course (24.43??2.53 mos versus 31.16??4.17 mos. P<0.01) in the PAOO group were significantly shorter than in the control. The modified PAOO accelerated orthodontic tooth movement in adult extraction cases with skeletal Class II discrepancy and convex profile; the modified PAOO achieved dual goals of periodontal health and long-term stability of orthodontics. Ultimately, this multidisciplinary approach and the use of translational 3D measurements constitute powerful tools that can be used to solve complex clinical problems.