Enhancing Orthodontic Treatment Efficiency Through Periodontally Accelerated Osteogenic Orthodontics (PAOO): A Case Report

AbstractBackground: Orthodontic space closure in adult patients is often challenging due to reduced bone remodelling capacity, prolonged treatment duration, and increased risk of periodontal complications. Periodontally Accelerated Osteogenic Orthodontics (PAOO) is a surgically assisted orthodontic technique that combines selective alveolar corticotomy with bone grafting to enhance regional acceleratory phenomenon (RAP), thereby facilitating faster and more stable tooth movement.Case Presentation: A 26 year old female patient presented with spacing in the maxillary left premolar region requiring orthodontic space closure. Considering the patient's age and the need to reduce overall treatment time while maintaining periodontal health, PAOO was planned as an adjunct to fixed orthodontic therapy. Following full thickness flap reflection, selective corticotomy was performed around the involved teeth. Orthodontic force application was initiated two weeks post surgery.Results: Rapid orthodontic tooth movement was observed with efficient space closure achieved within a significantly reduced treatment period compared to conventional orthodontics. Clinical evaluation revealed satisfactory alignment, stable occlusion, and improved periodontal parameters. Adequate alveolar bone levels with no evidence of root resorption or periodontal breakdown during follow-up was noticed.Conclusion: PAOO technique proved to be an effective and safe adjunctive procedure for accelerated orthodontic space closure in adult patients. This technique has reduced treatment duration, enhanced alveolar bone support, and predictable clinical outcomes, making it a valuable interdisciplinary approach in selected orthodontic cases.