Wilckodontics -  alternative adult orthodontic treatment method: rational and application

Objectives: Adult orthodontics poses a challenge for practitioners as it involves unique biomechanical consideration due to biologic age related changes and lack of skeletal growth potential. As modern life calls for quick and efficient orthodontic treatment, a novel orthodontic modality, Periodontally Accelerated Osteogenic Orthodontics (PAOO) or Wilckodontics with adjunctive periodontal surgery of bone corticotomy combined with bone augmentation was developed. The aim of this study is to describe in detail the clinical aspects of the technique and emphasize the concept, indications and rational for using PAOO in adult orthodontics.

Methods: Cases of six adult patients from both genders seeking a quick orthodontic solution for esthetic and functional disorders are presented. The variety of malocclusions requiring treatment included Angle class II and class III relationships, a constricted maxilla and maxillary dental arch, a bilateral posterior cross-bite and an anterior open bite. All cases were treated by a collaborative team of the Orthodontic and Periodontology Departments at the Rambam School of Graduate Dentistry, Haifa, Israel, using the PAOO technique.

 Results: PAOO enhances bone remodeling and augmentation. The biologic benefit and biomechanical consideration of profound enlargement in the envelope of motion reduces the need for extraction, orthosurgical treatment in borderline cases and eliminates the need for aggressive intervention such as surgically assisted Rapid Maxillary Expansion in adult patients.

 Conclusions: PAOO, an alternative adult orthodontic technique, may serve as a reasonable and safe option for the growing demand of shortened treatment duration of adult teeth movement in three dimensions.