Dental and Periodontal Changes After Accelerated Correction of Lower Anterior Teeth Crowding With Periodontally Accelerated Osteogenic Orthodontics (PAOO) Procedure: A Randomized Controlled Trial

Hallaj I Alsino; Mohammad N Kheshfeh; Mohammad Y Hajeer; Ahmad S Burhan; Issam Alkhouri; Heba M Al-Ibrahim; Jihad Nouman Abou Nassar

doi:10.7759/cureus.57347

Dental and Periodontal Changes After Accelerated Correction of Lower Anterior Teeth Crowding With Periodontally Accelerated Osteogenic Orthodontics (PAOO) Procedure: A Randomized Controlled Trial

Cureus. 2024 Mar 31;16(3):e57347. doi: 10.7759/cureus.57347. eCollection 2024 Mar.

Authors

Hallaj I Alsino¹, Mohammad N Kheshfeh¹, Mohammad Y Hajeer¹, Ahmad S Burhan¹, Issam Alkhouri², Heba M Al-Ibrahim¹, Jihad Nouman Abou Nassar³

Affiliations

¹ Department of Orthodontics, Faculty of Dentistry, University of Damascus, Damascus, SYR.
² Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Damascus, Damascus, SYR.
³ Department of Fixed Prosthodontics, Faculty of Dentistry, University of Damascus, Damascus, SYR.

Abstract

Objective To evaluate the relative efficacy of periodontally accelerated osteogenic orthodontics (PAOO) compared to conventional fixed appliances in correcting lower anterior teeth crowding using a non-extraction treatment approach. Material and methods A single-center, two-arm, parallel-group randomized controlled trial was conducted on 38 patients (9 males, 29 females) with moderate crowding. These patients did not require premolar extraction and were randomly allocated into two treatment groups: the PAOO group and the conventional orthodontic treatment group. The Little Irregularity Index (LII) measured crowding intensity on pre-treatment study models. Changes in this index were recorded monthly in both treatment groups. The inter-canine width, inter-second-premolar width, plaque index (PI), gingival index (GI), and papillary bleeding index (PBI) were also measured before and after the leveling and alignment stage. Statistical analysis between the two groups was performed using Mann-Whitney U tests. Results For the LII, the average time for irregularity resolution was three months in the PAOO group, compared to five months in the conventional orthodontic treatment group. Regarding changes in inter-second-premolar width, the PAOO procedure led to a significant decrease in the increase of inter-second-premolar width, with an average increase of +1.52 mm compared to +2.71 mm in the control group. For the GI and PBI, it was found that their values significantly increased with PAOO application, averaging 0.18 and 0.17, respectively, compared to 0.05 and 0.07 in the control group. Conclusions The use of PAOO in orthodontic treatment accelerated the leveling and alignment process by 40%. Changes in the inter-canine width, the inter-second-premolar width, and the status of periodontal tissues were minimal and clinically negligible.

Keywords: acceleration; inter-2nd premolars width; inter-canine width; levelling and alignment; little irregularity index; lower anterior teeth crowding; moderate crowding; paoo; periodontally accelerated osteogenic orthodontics; plaque index.