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Park Avenue Oral Maxillofacial & Implant Surgery - James Choi, MD, DMD, FACS l Wisdom Teeth l Dental Implants l Jaw Surgery l TMJ

Periodontally Accelerated Osteogenic Orthodontics (PAOO)

Your safety and comfort is our priority

Park Avenue Oral Maxillofacial & Implant Surgery - James Choi, MD, DMD, FACS l Wisdom Teeth l Dental Implants l Jaw Surgery l TMJ

What is PAOO?

PAOO (Periodontally Accelerated Osteogenic Orthodontics)—also known as accelerated osteogenic orthodontics (AOO), corticotomy-assisted orthodontics, or Surgically Facilitated Orthodontic Therapy (SFOT)—is an advanced surgical-orthodontic procedure designed to significantly speed up tooth movement while promoting healthier bone and tissue support.

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PAOO greatly enchances orthodontic treatment times, reducing orthodontic duration from 18–24 months to as little as 6–10 months. 

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Small incisions and cuts (corticotomies) in the jawbone to stimulate a Regional Acceleratory Phenomenon (RAP), a temporary surge in bone remodeling that softens bone structure for faster tooth movement. Bone grafts are also placed to enhance bone volume and support around the teeth. 

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PAOO is best for individuals with healthy gums and can benefit those with thin alveolar bone, root resorption risk, or bone deficiencies.

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Park Avenue Oral Maxillofacial & Implant Surgery - James Choi, MD, DMD, FACS l Wisdom Teeth l Dental Implants l Jaw Surgery l TMJ

Potential Complications

Since Regional Acceleratory Phenomenon(RAP) and the corticotomies(bone cuts) inherently weaken the jaw structure, your recovery period is indicated with an increased risk of injury.

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There is active and accelerated bone remodelling that is happening, so refrain from strenuous activity, bending, heavy lifting, or anything that may cause a blow to the mouth. Any large impact may cause a jaw fracture.

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Kundal, Sunegha & T., Shokeen,. (2018). ACCELERATED ORTHODONTICS-A REVIEW. International Journal of Development Research. 8. 18639-43.

Park Avenue Oral Maxillofacial & Implant Surgery - James Choi, MD, DMD, FACS l Wisdom Teeth l Dental Implants l Jaw Surgery l TMJ

How are PAOO done?

Anesthesia Options
We’ll help you choose the right anesthesia option based on your needs, level of anxiety, and medical history:

  • Local Anesthesia: Numbs only the area around the teeth. You're awake but feel no pain.

  • Nitrous Oxide ("Laughing Gas"): Used with local anesthesia to help you relax.

  • IV Sedation: You are deeply relaxed and may not remember the procedure.

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Procedure

Procedure typically takes 15–60 minutes, depending on the number of wisdom teeth:

  1. Preparation: Review orthodontist’s treatment plan and imaging (panoramic X-ray or CBCT scan).

  2. Anesthesia: Once anesthesia is administered, the area is completely numb.

  3. Accessing the Jawbone: A small incision is made in the gum to access the jawbone. Then, the full-thickness mucoperiosteal flap is lifted to expose the cortical bone.

  4. Corticotomy: Small, shallow cuts or perforations in the cortical bone is made to stimulate the Regional Acceleratory Phenomenon (RAP).

  5. Bone Graft: Bone graft is placed over the corticotomy sites to increase bone volume and support tooth movement.

  6. PRF: PRF is placed between the bone graft and gums to accelerate healing.

  7. Stitches: Dissolvable stitches may be placed to help the area heal.

  8. Immediate Orthodontic Activation: Orthodontist adjusts braces or aligners within 1–2 weeks to take advantage of the rapid bone turnover.

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Post-Operation Instructions

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