One of the big challenges in clinical orthodontics is the long treatment time that usually associates with side effects such as iatrogenic root resorption, white spot lesions, poor oral hygiene and compromised compliance. Therefore shortening the overall treatment time becomes a highly significant task for orthodontists. The overall orthodontic treatment time is determined by both biological (e.g. alveolar bone resorption leading to tooth movement) and non-biological (e.g. orthodontic appliance, mechanics and patient’s compliance) factors. Biologically, orthodontic tooth movement is a mechanically-induced modeling and remodeling of periodontium. To move teeth faster, historically several means had been explored e.g. local injection of biomolecules such as PGE2, herb extracts, and RANKL protein and gene construct. In recent years a surgical procedure - periodontally accelerated osteogenic orthodontics (PAOO) has been applied to help move teeth fast by increasing the regional turnover rate of bone (so called regional acceleratory phenomenon - RAP). Unfortunately, none of these has been efficaciously translated to clinical application mainly due to their invasiveness and surgical complications. More recently, two non-invasive methods i.e. low energy level of laser or LED and mechanical vibration have been proposed and applied to help move teeth faster, however with no support of solid scientific evidence. On the non-biological side, appliance selection, biomechanical considerations and patient’s compliance all contribute to the overall treatment time. In this presentation, all the currently available evidence for accelerating orthodontic treatment will be reviewed with regard specifically to their rationales, pros and cons, clinical applicability, effectiveness and efficacies.
Recognize the factors contributing to the orthodontic treatment time.
Compare the concepts and methods proposed to accelerate orthodontic treatment.
Evaluate the rationales, pros and cons, clinical applicability, effectiveness and efficacies of these methods.