Periodontally accelerated osteogenic orthodontics (PAOO)-an intense and fruitful collaboration between orthognathic surgeons and orthodontists

Periodontally accelerated osteogenic orthodontics (PAOO) has developed into an effective treatment for dentoalveolar and skeletal malocclusion. The regional acceleratory phenomenon occurs after deliberate damaging of the alveolar bone, resulting in a reduction in bone density for about 4 months. During this phase of remodeling in particular, an interdisciplinary approach with close orthodontic consultation is necessary. This 4-month phase of reduced bone density allows for accelerated tooth movement in the softer bone and avoidance of root resorption. The depicted PAOO procedure comprises a selective corticotomy, stippling, and augmentation with bone substitute material. The technique has become firmly established as a dentoalveolar treatment and also as a complementary measure during corrective osteotomy. PAOO has proven itself by accelerating conventional orthodontic processes, within a tight spectrum of extreme dentoalveolar transformations, and in selected cases for treatment of skeletal malocclusion only. If combined with a surgery-first concept or temporary anchorage devices, the treatment duration can be reduced to a quarter. In some cases of mild skeletal malocclusion, an osteotomy can be avoided. PAOO may also be offered in cases of mild relapse after osteotomy or following orthodontic treatment only.