*2.1.1.3.1 Corticotomy*

Corticotomy – it is a minor surgical procedure defined as osteotomy of cortical bone (**Figure 9**) [20]. Since the primary resistance to tooth movement is encountered in the cortical layer, corticotomy procedure makes it possible to move teeth faster without undesirable side effects [21].

How can corticotomy be used along with Orthodontics?


Suya suggested that most surgical and orthodontic procedures be performed in the first 3-4 months after corticotomy, before fusion of tooth bone units [22].

It is critical to begin the orthodontic movement immediately after the surgery, before bony healing occurs. Since it takes around 4 hours for the release of cAMP and as well as for bone remodeling to start; it will be better for us to activate the orthodontic phase of treatment immediately after the corticotomy procedure [23].

Frost coined the term, 'Regional Accelerated Phenomenon' (RAP), where he noticed that surgical healing occurred mainly at the surgical site due to the reorganization of cells and accelerated bone turnover rate.

The technique developed by the Wilckos, called the Wilckodontics system or Accelerated Osteogenic Orthodontics (AOO), is similar to single tooth corticotomy,

**Figure 9.** *Corticotomy done in the lower anterior region to induce the AOO phenomenon.*

except that it is extended to all the teeth to be moved during orthodontic treatment (**Figure 1**). This usually aids with correction of severe malocclusions and crowding.
