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2. Conventional Orthodontics
Pressure and tension in the PDL causes bone
resorption or deposition
Rate of tooth movement is limited by bone
resorption
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5. Biological Principles of AOO
Regional Accelerated Phenomenon
(RAP)
A large insult to bone (fracture, surgery) can
initiate a localized “burst” of remodeling to
repair the bone
Red = active bone resorption
Green = uncalcified osteoid
Gray = mineralized, mature
bone
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6. This remodeling induces Ca2+ release from
adjacent trabecular bone, causing localized
osteopenia
Osteopenia: Decreased calcification or
density of bone
Osteopenia can be induced by surgically
removing select portions of the alveolar cortex
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7. Osteopenia softens bone and allows for more
rapid tooth movement by orthodontics
Dr. Kole introduced this to single-tooth
orthodontics in 1959
Drs. Thomas and William Wilcko applied this to all
the teeth desired to be moved (1995)
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8. Selective decortication, followed by osteopenia
Remineralization begins 20-55 days after surgery
Orthodontic forces prolong remineralization (6
months?)
Complete recovery by 2 years
Bone grafts are used to increase bone height
and width
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