Periodontally Accelerated Osteogenic Orthodontics With Collagen Graft

Periodontally Accelerated Osteogenic Orthodontics (PAOO) not only shortens overall treatment duration but also effectively remodels alveolar bone, thereby expanding orthodontic indications. The conventional surgical approach involves placing bone graft material covered with the periosteum at the operative site. However, in this case, I will present a surgical patient where collagen-based bone substitute was utilized for bone augmentation. A 22-year-old female patient presented to our hospital with protruding upper and lower teeth and was seeking orthodontic treatment. Orthodontic referral for periodontal consultation. Clinical and radiographic examinations revealed thin gingival tissue on the labial side of teeth 33-43, with visible root contours. Cone-beam computed tomography (CBCT) showed thin labial alveolar bone and localized bone fenestration in the 33-43 region. Following discussing with the patient, PAOO was performed in the 33-43 area. Different from traditional approaches, collagen was used as a bone powder alternative for bone graft material covered with the periosteum in this bone augmentation procedure. At the 1-year follow-up, the gingival tissue in the lower anterior region appeared pink and firm. CBCT demonstrated increased labial bone thickness in the mandibular anterior region. For patients with bone fenestration, PAOO can effectively increase alveolar bone thickness and broaden the indications for orthodontic treatment. Compared to traditional bone substitutes, collagen achieves comparable augmentation with lower technical demands and expenditure. The application of collagen matrix in PAOO procedures demonstrates satisfactory clinical outcomes, providing valuable insights for future clinical practice.