Accelerating Tooth Movement: What Options We Have?

Duration of treatment is one of the main concerns of patients undergoing orthodontic treatment. Fixed orthodontic treatment lasts up to 2 to 3 years increasing the risk of external root resorption, periodontal problems and patient compliance [1]. Clinicians are constantly striving towards developing strategies to enhance the rate of orthodontic tooth movement. An increase in in-depth knowledge of the alveolar topography [2] has been a major aid in accelerating tooth movement. Corticotomies and multiple tooth osteotomies have been the main stay of surgically assisted rapid tooth movement. Corticotomy was first described in 1892 [3]. The concept of using a “positive system” for active canine retraction using a screw was proposed by Farrar [4]. Distraction osteogenesis in tooth movement was given by Liou and Huang [5]. Wilcko and Ferguson [6] demonstrated that tensional stress on a moving tooth through a surgically healing site led to faster tooth movement periodontally accelerated osteogenic orthodontics or Wilckodontics. In a systematic review by Hu Long [7], it was concluded that corticotomy is a safe and effective means of increasing the rate of tooth movement. Following corticotomy, there is alveolar osteopenia, followed by new bone deposition and osteoid formation, which can be supplemented using a bone graft [8]. Frost [8] called it regional acceleratory phenomenon whereby, regional healing response led to accelerated tooth movement. Several newer techniques like low level laser therapy, use of electric current, periodontal tissue activation by vibration, photobiomodulation have been discussed in this article.