Accelerated Orthodontics: A paradigm shift

Extended orthodontic treatment duration can be associated with increased risks of root resorption, periodontal disease, caries and changes or loss of patient motivation. Various attempts have been made to increase the rate of tooth movement while minimizing the associated side effects. It can be broadly classified into invasive, minimal invasive and non-invasive approaches. Surgically derived regional accelerations of orthodontic treatment i.e. PAOO, dento-alveolar & periodontal distraction and its modifications come under invasive category. Among minimal invasive methods, surgical procedure have been modified from raising a flap to flap less techniques such as peizosicion, corticision and aleveocentesis are becoming popular. Among the non-invasive methods various physical devices & pharmacological agents have been proposed. There have been several publications describing a positive effect of vitamin D, prostaglandin E1 and 2 Osteocalcin, parathyroid hormone, long-term or high dose corticosteroids and thyroxin on OTM. Although some of them were successful, the major drawback to most of these treatment interventions is the necessity for systemic delivery and the ensuing systemic side effects of pharmacological agents. Alternatively, local delivery requires repeated painful injections, necessitates demanding scheduling challenges with the need for repeated and frequent treatment. Physical devices like Acceledent, Orthopulse, Propel Device, Biolux & Aevo system have been tried to accelerate orthodontic tooth movement. Present article demonstrated practical utility of the above-mentioned techniques and associated difficulties considering Indian Orthodontic practice.