*3.3.5. Periodontally accelerated osteogenic orthodontics*

The method which is known as "Wilckodontics" or "periodontally accelerated osteogenic orthodontics" was introduced by Wilcko and Wilcko [9, 37–40]. According to the researchers, achieving optimal tooth movement is possible by forming a bone layer of 1.5 mm or less on the root surface in the direction of movement in corticotomy-assisted orthodontic treatment. When the force is applied, soft tissue matrix and osteoid islets remaining from the demineralized layer move with the root and remineralized when the orthodontic movement is completed. Wilcko brothers explained the acceleration of tooth movement following corticotomy with demineralization-remineralization period that is generated from rapid osteoclastic activity in alveolar bone in the beginning of "regional acceleratory phenomenon" which was introduced by Frost [24]. According to this mechanism, less resorption and rapid orthodontic tooth movement is achieved as a result of the decrease in alveolar bone density and increased metabolic activity in bone tissue. Thus, the term "movement of bone blocks" which was defined by Köle [27] was replaced with the term "bone matrix transplantation."

Wilcko and Wilcko discussed the need for applying a bone graft in order to prevent dehiscences, fenestrations, and relapses which can occur in posttreatment period due to the decrease in alveolar bone density within the cases with buccal move of the roots or thin buccal bones following corticotomy. They proposed to use resorbable bone graft by saturating clindamycin phosphate or platelet-rich plasma and creating circular perforations on the surface of the bone in order to increase blooding of graft material if the cortical bone thickness is sufficient [37]. The applied surgery apart from this procedure is almost the same with Suya procedure [32]. In this technique, bonding and applying forces to teeth is initiated 1 week earlier from the surgical intervention and biweekly orthodontic examinations are recommended.

Treatments are completed in three or four times shorter periods with "periodontally accelerated osteogenic orthodontics" method when compared to traditional orthodontic treatments besides its increased root resorption and relapse risks. Its need for additional surgical intervention with an extra cost, possibility of bone loss in alveolar crest, and gingival recession following the surgery and surgical complications such as pain and edema are among the disadvantages of the procedure.

#### *3.3.6. Corticision*

rigid device was used. Initially, the osteotomy curved apically at a distance of 3–5 mm from the apex of the canine at the same session with the primary premolar tooth extraction as a surgical preparation. Cortical bone which remained in the buccal of the socket after the extraction was carefully removed. Direct distraction was applied by skipping latent period similar to periodontal ligament distraction method. Canine distraction was reported to be completed within 8–12 days without anchorage loss. Root resorption or vitality loss was not observed in

Although a faster canine distalization is achieved with less teeth tilting in dentoalveolar distraction method when compared to periodontal ligament distraction method, it is clear to be

The method which is known as "Wilckodontics" or "periodontally accelerated osteogenic orthodontics" was introduced by Wilcko and Wilcko [9, 37–40]. According to the researchers, achieving optimal tooth movement is possible by forming a bone layer of 1.5 mm or less on the root surface in the direction of movement in corticotomy-assisted orthodontic treatment. When the force is applied, soft tissue matrix and osteoid islets remaining from the demineralized layer move with the root and remineralized when the orthodontic movement is completed. Wilcko brothers explained the acceleration of tooth movement following corticotomy with demineralization-remineralization period that is generated from rapid osteoclastic activity in alveolar bone in the beginning of "regional acceleratory phenomenon" which was introduced by Frost [24]. According to this mechanism, less resorption and rapid orthodontic tooth movement is achieved as a result of the decrease in alveolar bone density and increased metabolic activity in bone tissue. Thus, the term "movement of bone blocks" which was defined by Köle [27] was replaced with the term

Wilcko and Wilcko discussed the need for applying a bone graft in order to prevent dehiscences, fenestrations, and relapses which can occur in posttreatment period due to the decrease in alveolar bone density within the cases with buccal move of the roots or thin buccal bones following corticotomy. They proposed to use resorbable bone graft by saturating clindamycin phosphate or platelet-rich plasma and creating circular perforations on the surface of the bone in order to increase blooding of graft material if the cortical bone thickness is sufficient [37]. The applied surgery apart from this procedure is almost the same with Suya procedure [32]. In this technique, bonding and applying forces to teeth is initiated 1 week earlier from the surgical intervention and biweekly orthodontic examinations are

Treatments are completed in three or four times shorter periods with "periodontally accelerated osteogenic orthodontics" method when compared to traditional orthodontic treatments besides its increased root resorption and relapse risks. Its need for additional surgical intervention with an extra cost, possibility of bone loss in alveolar crest, and gingival recession following the surgery and surgical complications such as pain and edema are among the

the posttreatment evaluations.

78 Current Approaches in Orthodontics

a more invasive method [36].

"bone matrix transplantation."

disadvantages of the procedure.

recommended.

*3.3.5. Periodontally accelerated osteogenic orthodontics*

The necessity to remove flaps during corticotomy-assisted orthodontic treatment makes the method invasive, decreasing its acceptability by the patients and clinicians. Therefore, corticision was introduced by Park et al. [41] as an alternative approach for corticotomy procedures. The researchers made the patients rinse their mouth with an antiseptic mouthwash and then placed a stabilized scalpel on the attached gingiva interradicularly as to make an angle of 45–60 with the long axle of root of the teeth and applied cortical incisions via a surgical hammer without removing flaps [42]. Incisions were applied as 2/3 of the roots vertically and in 10 mm depth. Corticision area must be cleaned with physiological saline solution until hemorrhage stops. Park reported that fixed orthodontic treatment of a patient without extraction was completed in a short period of 10 months through this method. Although corticision method is minimally invasive with a short surgical intervention, it is not widely accepted as it is not appropriate to grafting and the surgical technique is disturbing for the patience.
