The clinical efficacy of periodontally accelerated osteogenic orthodontics in patients with bone fenestration and dehiscence: a retrospective study

Purpose: The objective of the study was to explore the effect of periodontally accelerated osteogenic orthodontics (PAOO) in orthodontic patients with bone dehiscence and fenestration in the anterior alveolar region of the mandible. Methods: : A retrospective study was performed in 42 patients with bone dehiscence and fenestrations in the anterior alveolar region of the mandible underwent the PAOO technique. Bleeding index (BI), probing depth (PD), keratinized gingiva width (KGW), gingival recession depth (GRD), and gingival phenotype were recorded and assessed at baseline, postoperative 6 and 12 months. Cone-beam computerized tomography was utilized for bone volume measurement in term of root length (RL), horizontal bone thickness at different levels and vertical bone height at baseline, 6 months and 12 months after the surgery. Results: : The sample was composed of a total of 42 patients (22 males and 20 females; mean age, aged 25.6 ± 4.8 years) with 81 teeth showing dehiscence/fenestrations and 36 sites presenting with gingival recessions. There was no significant difference in BI, PD, and KGW (between baseline, postoperative 6 and 12 months) based on the clinical evaluations ( P > 0.05). Gingival recession sites demonstrated a significant reduction in the GRD after surgery ( P < 0.05). Besides, the proportion of teeth with thick gingival phenotype was increased from 33.61% at baseline to 53.13% at the end of the follow-up. In addition, the bone thickness at mid-root and crestal level was markedly increased compared with the baseline records ( P 0.05). Moreover, alveolar bone height was also remarkably increased at postoperative 6 month compared with the baseline records ( P < 0.05). Conclusions: : Within the limitations of the study, the obtained results show that PAOO technique is beneficial to periodontal conditions in terms of soft and hard tissue augmentation. PAOO procedure may represent a safe and efficient treatment for orthodontic patients with bone dehiscence and fenestration. Trial registration: This study was approved by the ethics committee of stomatological hospital affiliated to Xi'an Jiaotong University (xjkqll[2019]NO.016) and registered in Chinese Clinical Trial Registry (ChiCTR2100053092).