Periodontally Accelerated Osteogenic Orthodontics (PAOO): biological principles, clinical applications, and evidence-based perspectives

Periodontally Accelerated Osteogenic Orthodontics (PAOO) is a surgical adjunctive approach to conventional orthodontic therapy, primarily aimed at significantly reducing treatment duration through the activation of regional bone metabolism. This narrative review aims to critically examine the biological foundations, main clinical indications, therapeutic advantages, and potential limitations associated with PAOO. The review integrates the most current and relevant scientific literature, with emphasis on the underlying pathophysiological mechanisms, diagnostic criteria, interdisciplinary planning, surgical protocols, and subsequent orthodontic management. Additionally, the level of predictability and safety of the procedure is analyzed, along with its clinical implications in contemporary orthodontic practice.