More is Better: A Revisionist Story of Accelerated Tooth Movements

Orthodontists have been trying to surgically accelerate tooth movements for over 100 years. Over the past 20 years, less and less invasive procedures have been introduced, and rates of tooth movement have decelerated. The only way to increase rates of tooth movement through intact bone is by decreasing the amount and density of bone through which the teeth have to be moved. The greater the reductions, the greater the rates of tooth movement. This can be accomplished by increasing the extent of the injury produced. A better approach – one that has the potential for the fastest movements – is to remove the bone impeding tooth movements, closing the space created surgically before healing occurs. This requires dentoalveolar or periodontal distraction osteogenesis – procedures that allow uni- and multi-radicular teeth to be moved up to 1 mm/day while remaining vital and healthy.

Learning Objectives:

• Understand why rates of tooth movements decrease when less invasive procedures are used.
• Recognize the importance of the amount and density of bone in determining rates of tooth movement.
• Be made aware of the potential of periodontal and dentoalvolar distraction osteogenesis for producing the fastest tooth movements possible.