ABSTRACT
The periodontal disease is initiated by microbial plaque, which accumulates in the gingival crevice & induces an inflammatory response. This inflammation leads to chronic gingivitis, which is reversible & may later progress as periodontitis, by destruction of bone & other tooth-supporting structures. Although present in most of the population, the risk for periodontal disease is not uniform for all individuals. About 10-15% of the population develops severe destruction of the periodontal structures leading to early loss of the tooth. This inflammatory response leading to periodontal destruction is assumed to have a genetic basis. It is now recognized that poor oral hygiene alone cannot account for severe destructive periodontal disease, that certain individuals are at relatively high risk of periodontal destruction and that the risk is partly under genetic control. The microbial causation of the inflammatory periodontal disease is well established. There are however other elements that influence the inflammatory and immune response both locally and systemically. These include systemic disease such as diabetes and environmental factors such as smoking and possibly stress. The effectiveness of an individual’s immune response may influence the extent of periodontal destruction. The role of genetic factors in the causation of peridontitis is worthy of in depth discussion.
ABSTRACT
The orthodontic treatment is, perhaps, in terms of duration, the longest-performed dental procedure. In this fast-paced world any treatment that would consume 1 – 2 years is unwelcome. It is universally accepted that if the duration of the orthodontic treatment is reduced, there will be an increased favorable attitude towards the orthodontic therapy. To accelerate the tooth movement the orthodontists and the periodontists together have worked out a success formula which is termed Periodontally Accelerated Osteogenic Orthodontics (PAOO) or wilckodontics. Theoretically this procedure is based on the healing property of bone known as (RAP) regional acceleratory phenomenon. This procedure involves the surgical demineralization of the cortical bone (corticotomy) thereby decreasing the resistance offered by the cortical bone of the teeth to the orthodontic force applied and use of particulate bone grafting. This method not only enhances the width of the alveolar bone but also decreases the duration of the treatment and chances of apical root resoption. It also increases the stability of the treatment by reducing the chances of relapse. A proper case selection, careful surgical procedure and accurate orthodontic movements are important for the success of wilckodontics. This review article includes history, biomechanics, indication, contraindication, case selection, treatment planning, surgical techniques and its modifications.