Background and objectives: Heinrich Kole first introduced the corticotomy procedure to accelerate tooth movements, Epker and others modified the technique but corticotomy surgery has gained little acceptance in the modern era of orthognathic surgery. Wilcko et al. introduced a technique combining coorticotomies, stippling and alveolar ridge grafting. The technique termed AOO or Wilckodontics has been shown to be very successful in correcting dental malocclusions. The purpose of this paper is to report the author’s results combining AOO and orthognathic surgery.
Methods: The author reviewed 30 cases in which both AOO and orthognathic surgery was utilized. The type of deformity, the treatment time frame, sequencing of surgeries and any complications were analyzed.
Results: A retrospective study of the 30 cases surveyed showed that the average set-up time for orthognathic surgery was 17 weeks. This resulted in the orthognathic surgery being performed in 1/3 to 1/4 of the time normally required utilizing conventional orthodontia. Furthermore, the average total treatment time for correcting all of the cases was 34 weeks.
Conclusions: Combining AOO with orthognathic surgery results in an exceptionally fast timeframe for correcting dento-facial deformities. The results are stable with a reproducible occlusion and a minimum of post-operative complications. Furthermore, it is advantageous in that pre-treatment bone dehiscences and fenestrations remain covered as confirmed by CT scans. The AOO surgery can be performed as an outpatient (office type) procedure, resulting in less hospital operating time and costs. The need for surgically assisted rapid palatal expansion (SARPE) and muti-piece osteotomies has been eliminated with this approach.
Key words : AOO; Wilckodontics; orthognathic surgery; RAP; dento-facial deformities